Work-related quality of life (WRQoL) is a crucial aspect of overall well-being, particularly for medical interns who face unique challenges in their demanding environment.

This study aims to assess factors associated to work-related quality of life in a population of Tunisian Medical Interns.

A cross-sectional study was conducted from July to September 2024 among Tunisian medical interns using a Google Form’s questionnaire. They were asked about their sociodemographic characteristics and their working conditions such as number of working hours per day, number of night shifts per month, and number of patients seen per day. Quality of working life was measured using the the Work-Related Quality of Life (WRQoL) Scale which covered six domains: General Well-Being (GWB), Home-Work Interface (HWI), Job and Career Satisfaction (JCS), Control at Work (CAW), Working Conditions (WCS) and Stress at Work (SAW).

Our study included 141 interns with a mean age of 27.28 ± 2.42 years. Among them, 31 (22.1%) were married. The average working hours per day was 6 .42 hours, and the average number of patients seen per day was 12 patients. The average nightshifts done per month was 6. Age was statistically positively associated with all WRQoL’ domains. However, GWB and HWI were negatively associated with number of working hours per day (p=0.022 and 0.026 respectively) and number of night shifts per month (p=0.001 and 0.000 respectively). Moreover, JCS, CAW and WCS were negatively associated with number of night shifts per month (p=0.007, 0.002 and 0.000 respectively).

This study highlights the significant factors influencing work-related quality of life among Tunisian medical interns such as working conditions. By addressing these factors, it is possible to enhance the overall quality of life for medical interns, thereby promoting their well-being and improving their capacity to provide quality patient care.

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Conflicts concerning land ownership and inheritance disputes among older adults are prevalent and often lead to extreme and criminal behaviors. Even seemingly insignificant differences, such as disputes over a few square meters of land or a single tree, can escalate into violence or homicide.

This study aims to examine these phenomena through the lens of the fragmentation of the “good object,” as well as the accompanying sense of urgency experienced by older adults. This fragmentation refers to the loss of emotional and psychological foundations that provide a sense of security and identity. The study explores how these seemingly minor disputes, when they threaten the “good objects” of older adults, combined with their intense urgency to resolve these issues before it is too late, can turn into serious identity crises, potentially leading to extreme behaviors.

Through the analysis of case studies and a psychoanalytic approach, the psychosocial factors influencing older adults’ decisions regarding the management of their property and their emotional connections to these assets are examined.

The findings reveal several key factors contributing to these conflicts, including: a) Emotional attachment to property stemming from years of hard work, b) Inheritance tensions and a sense of injustice, c) Financial insecurity, which makes property the most valuable asset for survival, d) Psychological pressure and isolation, which may lead to unpredictable behaviors, e) Lack of emotional control and traditional perceptions of honor and dignity, f) A sense of loss of control as they age and the need to defend what they deem important.

The psychoanalytic interpretation of these phenomena reveals that the fragmentation of the good object, which may be land or other property, is closely tied to the identity and mental well-being of older adults. These individuals experience an intense sense of urgency, as delays in resolving their legal issues can mean the loss of their identity. This urgent need to protect their “good objects” often leads to reactions, frequently violent, stemming from despair and the perception that their social fabric is abandoning them. For older adults, legal and property disputes are not merely material concerns but represent their last struggle to maintain their identity. It is essential to recognize the importance of these issues and provide them with the value they deserve.

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The Recovery Assessment Scale-Domains and Stages (RAS-DS) is a recently developed measure that builds on the original Recovery Assessment Scale (RAS). Within the RAS-DS, which measures one’s recovery from mental illness, a specific domain is called “Clinical Recovery” (RAS-DS-CR). It extends the “Not Dominated by Symptoms” subscale of the original RAS, which only has three items. The RAS-DS-CR provides a more comprehensive assessment of the sense of control over symptoms and is a promising, easily-administered outcome measure for evaluating early interventions such as psychoeducation and skills training programs.

This study examined the psychometric properties of the 7-item RAS-DS-CR in a Chinese sample of treatment seekers.

We analyzed data from 91 participants from a two-month psychoeducation program (Mage = 28.87; SD = 7.84, 89.0% female). At baseline, they exhibited high levels of post-traumatic (mean PCL-5 = 57.18; SD = 14.68) and dissociative (mean DES-T = 47.90; SD = 23.13) symptoms. All participants completed the baseline assessment, 83 completed the 2nd pretest, 58 completed the posttest, and 44 completed the two-month follow-up test. They completed the RAS-DS-CR and other validated self-report measures at each time point.

The RAS-DS-CR revealed good internal consistency (α = .805 to .871) at each time point. Intraclass correlations of two tests taken pre-intervention (ICC = .524, p <.001) and post-intervention (ICC = .613, p <.001) indicated moderate test-retest reliability. At each time point, the RAS-DS-CR was significantly correlated with self-esteem (r = .338 to .574), depressive symptoms (r = -.402 to -.486), and PTSD symptoms (r = -.245 to -.462), indicating its construct validity. The paired sample t-test also suggested that participants scored significantly higher on the RAS-DS-CR post-intervention compared to pre-intervention (t = -4.330, p < .001; Cohen’s d = 0.56), providing evidence for its sensitivity to change.

This study provided new evidence for the reliability and validity of the RAS-DS-CR. The RAS-DS-CR is a short and easy-to-use outcome measure of one’s mental health recovery in terms of the confidence in symptom management.

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All older adults have a strong desire to age healthily and successfully. Because of this, the research community has extensively researched various influences on an older person’s aging experience. One of those influences is music, which is associated with a positive impact on the aging experience and contributes to an individual’s health, wellness, and quality of life.

This study aims to explore the relationship between older adults’ mental health and music listening.

A self-report survey was employed in this study with 168 people over the age of 65, using a convenience sample. The survey had two parts: the first part included socio-demographic information and a variety of music and listening factors, while the second part was a health-related quality of life assessment—the SF-36.

The Mann–Whitney statistical test was used to examine the hypothesis that the mean total score of the SF-36 mental health subscale is different between participants who identified as enjoying music listening and those who did not. Participants who identified as enjoying music listening had a significantly higher overall mental health total score (median = 74.5) than participants who did not enjoy music listening (median = 66.2), U (Enjoy = 38, No Enjoy = 130) = 3037, z = 2.150, p = 0.032.

Music has a positive influence on both mental and physical health in older adults. Listening to music or participating in music-making in late life can positively affect quality of life, particularly for older adults.

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Familiarity with, social distance from people with mental illness and socio - demographic characteristics has been linked to conditions that lead to weaker prejudiced beliefs and a more positive opinion about mental illness.

The relation of the attitudes and perceptions of the citizens of Larissa city towards mental illness and their desire for social distance from the mentally ill people, in relation to their familiarity with mental illness and their demographic characteristics.

A convenience sampling survey was conducted in Greece, Larissa City (n=220). The research tools which were used were: a) Familiarity was assessed using the Level of Contact Report, b) The Social Distance Scale, to measure the desire for social distance from people with mental illness c) Attitudes about mental illness were assessed using The Opinions About Mental Illness (OMI) Questionnaire and finally d) a questionnaire for the socio - demographic information.

Univariate and multivariate analysis was applied for the statistical analysis of the data, which showed that: Desire for social distance from people with mental illness is positively related with the familiarity (with mental illness) but on the other hand is negatively related to the opinions / attitudes about mental illness.

The results from this study highlight and emphasize the important role of familiarity (with mental illness) and the desire for social distance (from people with mental illness) in the formation of positive/negative (prejudiced) attitudes and perceptions about mental illness.

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The escalating burden of occupational stress and chronic health issues among healthcare professionals frequently culminates in burnout syndrome.

This study proposes the development of a prototype mobile recommendation system that utilizes the Internet of Medical Things (IoMT) for health monitoring and burnout assessment, while simultaneously offering coping strategies for healthcare professionals.

A digital framework was conceptualized using the Unified Modeling Language (UML), which outlined the system’s modules and graphical interfaces. The proposed system integrates a range of biometric sensors, including an electrocardiogram (ECG), a blood pressure monitor, a blood oxygen saturation monitor, and temperature sensors, complemented by a psychometric assessment tool to evaluate burnout syndrome.

The results of this study demonstrate that the proposed system can offer significant benefits in terms of promoting physical and mental well-being. By functioning as a continuous health monitoring tool and a preventive measure against stress and chronic illnesses, the proposed system can enhance the resilience of healthcare professionals.

The proposed system not only facilitates proactive health surveillance but also delivers targeted interventions to alleviate burnout effects. The implementation of this technology could revolutionize mental health management in the workplace, paving the way for robust health policy formulation within medical institutions.

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There is clear evidence on the physical and psychological benefits of a bodily approach for the treatment of psychiatric disorders. They can have a significant impact on the patient’s perceived suffering (Carek et al. IJPM 2011; 41(1) 15–28). In January 2024, a Physiotherapy Project started at the Acute Psychiatric Service of the Rieti ASL in collaboration with the Physical and Rehabilitation Medicine service.

Evaluate the impact of the physiotherapy program on psychopathological dimensions and on the patients subjective well-being.

The naturalistic study was conducted on subjects consecutively hospitalized at the SPDC from January to June 2024 who voluntarily joined the physiotherapy activity. The intervention was administered with bi-weekly sessions of about 45 minutes and included: stretching, orientation exercises, active movement, coordination, muscle strengthening. The Exclusion Criteria were: sedation status, disorganization, behavioral problems. The General Health Questionnaire-12 (GHQ-12) and the Brief Psychiatric Rating Scale (BPRS) were adminstred at admission (T0) and discharge (T1). A Self-evaluation of the useful of the program was administred only to discarege (T1): participants answered by choosing between “not useful”, “partly useful”, “very useful” to 4 questions on the usefullness of the intervention.

Thirty-five participants (17 M, 18 F; mean age 38.2±15,4) were admitted to physical activity. They recieved the following diagnoses: 48.6% Psychotic Disorder, 20% Depressive Disorder, 2.9% Bipolar Disorder, 28.6% Personality Disorder. Eleven of 35 participants had comorbid substance use disorder (14.3% alcohol, 5.7% cocaine, 5.7% cannabis, 2.9% opioids, 2.9% other substances). The hospitalization time was 11.8±4.3 and the average number of physical sessions was 1.7±0.8. The BPRS (44.4±11vs25.9±4.5; F=1024.25; p<0.001) and GHQ-12 (24.6±4.9vs15.11±5.8; F=833,43; p<0.001) mean scores significant improved in two time of evaluation (T0 and T1).

Participants showed a reduction in psychopathological severity and an increase in perceived well-being between T0 and T1. They found useful to practice physioterapy during hospitalozation and to manage anxiety, muscle relaxation and mood improvement.

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The existing studies found that stigma expands also among healthcare professionals when it comes to psychiatric patients, where a particular group is represented by substance use disorder patients, who are often perceived as manipulative, irresponsible or non-compliant.

The aim of this case presentation is to emphasize the importance of stigma reduction especially among healthcare professionals.

A 26-year-old female patient with medical history of treatment-resistant epilepsy and misuse of cannabis and alcohol was brought into the Psychiatry ward after multiple grand-mal seizures, which occurred after weeks of daily use of alcohol and no adherence to the medical treatment.

Prior to the admission, the patient was directed to the Neurology ward, where the hospitalization was declined due to her psychiatric history and the multi-drug test result, which turned positive for THC.

On the first day after admission, the patient had two seizure episodes, lasting 10 and respectively 30 minutes, after which she was transferred to the ICU department, where she was stabilized. Therefore, she returned to the psychiatric ward, where the patient enters status epilepticus, for which she underwent an neurological examination and received emergency treatment successfully.

The following day, the patient presents another episode of status epilepticus, after which she does not recover her respiratory function spontaneously and suffers cardiac arrest. The resuscitation protocol was initiated, an Emergency Medical team was requested to take over. After 4 minutes of CPR, the patient became pulmonary and hemodynamically stable.

Stigma is one of the factors that can influence the quality of the healthcare services provided by physicians. In the given case, stigma led to a life-threatening scenario, in which the patient was denied to receive adequate neurological treatment due to cannabis and alcohol use disorder. The impact of stigma on healthcare delivery and the barriers to receiving adequate treatment in these cases emphasize the need for training and education for all healthcare professionals.

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Research has consistently highlighted the vulnerability of medical students to poor mental health and wellbeing. The COVID-19 pandemic has further exacerbated this issue. However, there is limited understanding of medical students’ mental wellbeing dynamics after the pandemic.

The aim of the study was to comparatively analyse the mental wellbeing and mental health needs of medical students in comparison with those during the COVID-19 pandemic.

An anonymous structured online survey was conducted among students of a medical institute in St. Petersburg, Russia. The sample included responses from 152 students (76.3% women) of all courses of study. The results were compared with the data of a survey conducted at the same institute in 2020 (Chumakov et al. Middle East Curr Psychiatry 2021;28, 38).

The majority of respondents (n=145; 95.4%) reported experiencing significant stress in their lives (95.8% in 2020). The main sources of stress included education-related factors (83.6%), uncertainty about the future (72.4%), financial problems (48.0%), intimate/family relationships (46.7%), work (27.6%), and housing problems (19.1%). Thirteen students (8.6%) reported that they had been diagnosed with a mental health disorder prior to enrolling in the institute (6.1% in 2020; p=0.393). Twice as much students (n=27; 17.8%) were diagnosed with mental disorders during institute studies (15.2% in 2020; p=0.53). The mental disorders reported by the respondents were dominated by depressive disorders (n=7), anxiety disorders (5), mixed anxiety and depressive disorder (5), ADHD (5), bipolar disorder and cyclothymia (3). At the time of the study, 26 students (17.1%) were being seen by a mental health professional (10.9% in 2020; p=0.111), the same number of students were taking any prescribed medication for mental health (10.9% in 2020; p=0.111). One-third of respondents (n=53; 34.9%) had taken non-prescription medication in the last year to improve their well-being or mood (27.3% in 2020; p=0.143), and 45 (29.6%) had taken medication in the last year to improve concentration or academic performance (38.3% in 2020; p=0.107).

The study showed high mental health care needs among medical students with a tendency to self-medication. Notably, mental health indicators have not improved since 2020 despite the end of the COVID-19 pandemic. Our findings highlight consistent trends in medical students’ mental health and underscore the need for targeted interventions to support this vulnerable population.

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The increasing prevalence of shift work, particularly night shifts, in modern industrial settings has raised concerns about its potential detrimental effects on workers’ health. Disruptions to circadian rhythms, sleep deprivation, and social isolation associated with night shift work have been linked to a range of physical and mental health problems.

This study aims to investigate the specific impact of night shift work on the mental health outcomes of Tunisian industrial workers.

This is a cross-sectional study carried out during 3 years among active workers working in the inter-company occupational health services of Sousse. All participants had a fixed night work schedule. Data collection was based on a pre-established anonymous questionnaire. Job strain was assessed with Karazek questionnaire.

A total of 453 employees were included in our study. Mean age was 32.12 ± 7.68 years. Half of the participants were women (52%). Sixty percent of participants were not married. Tobacco consumption was identified among 26% of the participants. The most affected sector of activity was the electronic one (63%). The average occupational seniority was 7.78 ± 6.407. Job strain was revealed in 23.4% of employees. High psychological demand was noted among 46.5% of cases. Low job control was identified among 57,4% of participants. Low social support was noted among 68% of participants.

These results underscore the need for targeted interventions to protect the health and well-being of night shift workers. Future research should explore the effectiveness of various strategies, such as scheduling modifications, workplace accommodations, and health promotion programs, in mitigating the negative impacts of night shift work.

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There has been an increasing socio-medical discourse on the humanitarian approach to the use of restraint in psychiatric inpatient units.

It is necessary to investigate the attitudes of psychiatric hospital staff toward the use of restraint in psychiatric inpatient units and to identify the factors influencing these attitudes.

This study examined the attitudes of psychiatric hospital staff toward the use of restraint in situations involving physical violence toward other patients, verbal violence toward other patients, physical violence toward staff, verbal violence toward staff, and disruption of the treatment environment. The study also investigated factors related to the considerations and perceived burdens (both legal and medical) associated with the use of restraint, comparing these findings with data from a survey conducted 10 years ago.Attitudes toward restraint were not significantly associated with gender, age, or years of service. However, staffs who exhibited less prejudice toward mental illness-related crime were less likely to find restraint necessary. Compared to 10 years ago, there was little change in the need for restraint in cases of physical violence (both toward patients and staff), but the need for restraint in response to verbal violence (toward both patients and staff) had decreased. The perceived burden, both legal and medical, associated with the use of restraint had increased.

Attitudes toward restraint were not significantly associated with gender, age, or years of service. However, staff who exhibited less prejudice toward mental illness-related crime were less likely to find restraint necessary. Compared to 10 years ago, there was little change in the need for restraint in cases of physical violence (both toward patients and staff), but the need for restraint in response to verbal violence (toward both patients and staff) had decreased. The perceived burden, both legal and medical, associated with the use of restraint had increased.

Psychiatric hospital staffs with less prejudice toward mental illness-related crime were less likely to perceive a need for the use of restraint. Compared to 10 years ago, the necessity of restraint in cases of verbal violence has decreased, which may be attributed to ongoing human rights education and increased legal and medical concerns. These findings provide important insights for future policy development aimed at promoting humanitarian approaches, such as non-restraint treatments.

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Healthcare workers, faced with increasingly demanding professional requirements, are particularly exposed to psychosocial risks. These psychosocial factors have direct repercussions on their work capacity, potentially compromising their professional performance and increasing the risk of medical errors.

To study the influence of psychosocial factors on the work capacity of healthcare workers.

This is an analytical cross-sectional study conducted among healthcare staff at Sahloul University Hospital in Sousse over a 3-month period. Our study was based on a questionnaire that included socio-professional characteristics, Karasek’s model, and the Work Ability Index (WAI).

One hundred and thirty-seven staff members were included in this study, with a response rate of 72.4%. The mean age was 48.7 years, with a sex ratio of 0.57. A low work ability (WAI) was reported in 37.1% of cases. A high psychological demand at work was noted in 24.8% of cases. Job strain was reported in 18.1% of cases. Low WAI scores were statistically associated with age (p<10-3), female gender (p<10-3), lack of physical activity (p = 0.03), professional seniority (p<10-3), and high psychological demand at work (p<10-3). No association was found between low decision latitude, low social support, and WAI scores.

The results of this study highlight the significant impact of psychosocial factors on the work capacity of healthcare staff. Preventive measures in healthcare settings to improve working conditions and preserve the mental health of caregivers are essential.

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Anesthesia and critical care professionals are particularly vulnerable to burnout due to the demanding nature of their work, including long hours, night shifts, high-stress situations, and the constant risk of medical errors. Emotional intelligence (EI) has emerged as a crucial factor in fostering positive professional relationships and mitigating burnout.

To study the association between EI and burnout among healthcare workers in anesthesia and critical care settings.

This is a cross-sectional descriptive and analytical study conducted over a period of 3 months in 2024. It included 72 healthcare workers in the anesthesia and critical care departments at the Sahloul University Hospital in Sousse. The survey was based on a self-administered questionnaire, including data on socio-demographic and professional characteristics, the Maslach Burnout Inventory (MBI), and the Schutte Self-Report Emotional Intelligence Test (SSEIT).

The majority of participants were female (58.3%) with an average age of 33 years. Most participants (61.1%) were nurses, and 40.3% worked in the surgical critical care unit. The average EI score was 103.26. Among the EI factors, emotion perception was the most affected, with a score of 30.69 ± 9.34. EI levels were low in 11.1% of cases. Severe burnout was present in 19.4% of participants, and 65.3% had a high emotional exhaustion (EE) score. Additionally, 70.8% had a high depersonalization score, and 58.3% exhibited low personal accomplishment. EI levels was statistically associated with time spent with family and friends (p = 0.027). Among the professional factors, job satisfaction was significantly associated with EI level (p = 0.001). The factors significantly associated with severe burnout were the absence of alcohol consumption (p = 0.000) and the absence of time spent with loved ones (p = 0.033). A significant relationship between EI and self-emotion management and EE was reported (p = 0.040).

EI is crucial for preventing burnout among healthcare workers in anesthesia and critical care. By enhancing positive attitudes, managing stress, and improving interpersonal skills, EI can improve work life and patient care. Incorporating EI training into health science curricula can equip future providers with essential tools for well-being.

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The prevalence of stress and emotional disorders among medical students has risen dramatically in recent years. In response, it is essential to develop prevention strategies, such as emotional intelligence (EI), to better manage stress and preserve mental well-being.

To evaluate the level of EI among medical students and study its relationship with perceived stress.

This cross-sectional, analytical study was conducted among medical students at the Faculty of Medicine, Sousse, from March 2023 to February 2024. Participants completed a questionnaire assessing perceived stress using the Perceived Stress Scale (PSS10), emotional intelligence using the Schutte Emotional Intelligence Test, and lifestyle habits including sports participation and psychoactive substance use.

The study included 207 students, with a majority being female (87.7%). Among them, 88.4% had no psychiatric history. Alcohol consumption was noted in 36 students, while 10 participants reported cannabis use. Regular physical activity was observed in 64.3% of cases. Students with lower EI scores generally exhibited higher stress levels, especially in the absence of sports or extracurricular activities. While correlations between EI and stress were evident, univariate analysis did not reveal a statistically significant direct association (p=0.416). Psychiatric symptoms, including anxiety and emotion regulation difficulties, emerged as significant factors in stress modulation, independent of EI levels.emotion regulation appeared to play a major role in stress modulation, independent of EI.

EI emerges as a critical factor in enhancing resilience against stress among medical students. By developing a more profound understanding and effective regulation of emotions, students can significantly elevate their mental and emotional well-being.

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Recent events in Tunisia have highlighted the severe challenges faced by young doctors, including high stress levels, burnout, and mental health issues.

This study aims to shed light on the often-invisible realities of the medical profession in Tunisia by exploring the impact of working conditions and health policies on the mental health of young doctors.

This multicentric cross-sectional study collected data from 385 interns and residents working in four main university hospitals in Tunisia. The questionnaire included sections on sociodemographic characteristics, satisfaction with working conditions, burnout symptomatology (MBI), and anxiety and depressive symptomatology (HADS).

Most respondents (82.6%) were aged 25-29, with 73% being women. Most participants (83.1%) were residents. The study \revealed widespread dissatisfaction with working conditions, including remuneration (82% dissatisfied), days off and rest periods (73% dissatisfied), and overall working conditions (78% dissatisfied).

The average emotional exhaustion score was 31.883 (SD=10.2), indicating a high degree of burnout. Depersonalization scores averaged 10.176 (SD=6.3), and personal accomplishment scores averaged 23.838 (SD=8.7). The mean anxiety score was 8.776 (SD=4.2), and the mean depression score was 7.774 (SD=3.9), indicating moderate levels of anxiety and depressive symptoms.

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The results paint a concerning picture of the mental health status of young doctors in Tunisia, with high levels of burnout, anxiety, and depression strongly correlated with poor working conditions and work-life imbalance. These findings highlight the urgent need for comprehensive reforms in the Tunisian healthcare system, including policy changes, organizational support, and improved medical education. Limitations include the cross-sectional nature of the study and potential self-reporting bias. Future longitudinal studies are needed to understand the long-term impacts of poor working conditions on physician mental health and career trajectories.

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Workaholism, or work addiction, is a compulsive drive to work excessively, often at the detriment of personal and professional well-being. This behavior is associated with increased risk of burnout and psychosocial disorders. While understudied in healthcare workers, the constant connectivity and demands of the healthcare profession can exacerbate workaholism. Occupational health teams must prioritize addressing this issue to mitigate its negative consequences.

To study the factors associated with workaholism among healthcare workers and to assess its impact on mental and physical well-being.

A cross-sectional descriptive study examined the determinants of workaholism and its impact on quality of life among healthcare workers at the Farhat Hached University Hospital in Sousse, from March 2022 to June 2022. The Work Addiction Risk Test (WART) was used to assess workaholism and The Hospital Anxiety and Depression Scale (HAD) to measure mental health symptoms.

A total of 117 questionnaires were completed by healthcare workers, representing a response rate of 68.8%.The average age of participants was 35.45 years, with a female-dominated population (81.2%). Nurses comprised the largest group (73.5%), and most participants had less than 10 years of experience in their current department. Shift work was common, with 74.4% of participants working shifts. The Work Addiction Risk Test (WART) revealed that 18.2% of healthcare workers were at risk of work addiction, including 13.7% at moderate risk and 5.1% at high risk. The Hospital Anxiety and Depression Scale (HAD) indicated that 54.7% of participants suffered from anxiety and 35% from depression. A significant association was found between anxiety scores and a high risk of work addiction (p=0.003).

This study highlights the potential for workaholism among healthcare workers, particularly those facing challenging work conditions such as shift work, heavy patient loads, staff shortages, and high levels of stress. Further studies with larger and more diverse samples are necessary to better understand the prevalence and impact of workaholism among healthcare professionals mental heath.

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A history of psychiatric disorders significantly impacts patient evaluation and treatment in healthcare. Nearly 80% of excess mortality in individuals with mental illnesses is due to physical health issues. While suicide risk is widely recognized, most mortality from mental illnesses stems from physical conditions like cardiovascular diseases, respiratory issues, and cancer, leading to a life expectancy reduction of 15-20 years compared to the general population.

To exemplify through a case the possible impact of psychiatric history on healthcare provision.

We present the case of a 55-year-old woman with a history of severe functional neurological disorder resulting in mobility limitations, dyskinetic movements, and functional pain characterized as allodynia. She has been followed by neurology for the past year. She began mental health follow-up one year earlier due to reactive anxiety stemming from work-related issues. Her substance use history includes being a tobacco smoker for over 20 years (FTND score>50) and a former consumer of three liters of beer daily for two years, with periods of abstinence. The patient presented to the emergency department due to weight loss and low mood, worsening over the past few weeks, in the context of intense muscle pain and loss of strength. Blood tests and a brain CT scan were performed without abnormalities. She was initially admitted to Neurology for severe functional neurological disorder for symptom control, but was later transferred to Psychiatry due to suicidal threats. During her psychiatric admission, she experienced improvement in pain and subsequently in her mood. After discharge from psychiatry, the patient returned several times to the emergency department due to worsening neurological symptoms, being discharged with a diagnosis of functional disorder.

Two months after her discharge from psychiatry, the patient returned to the emergency department due to rib pain. After emergency assessment, she was referred to Neurology for worsening neurological symptoms. With suspicion of paraneoplastic polyneuropathy, an MRI of the brain and spine, EMG, lumbar puncture, and CT scans of the neck, chest, abdomen, and pelvis were performed during her neurology admission. She was diagnosed with small cell lung carcinoma stage IVA and asymmetric paraneoplastic sensory neuropathy. Following the diagnosis, she was referred to Oncology, receiving one cycle of chemotherapy. However, given the unfavorable progression, it was decided, in agreement with the patient, not to continue active oncological treatment, and she was transferred to a Palliative Care Center.

This case emphasizes the need to recognize how psychiatric history affects medical care. Stigma and the patient’s challenges in communicating symptoms can hinder the diagnosis and treatment of organic conditions, contributing to the excess mortality associated with mental health issues.

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Healthcare workers (HCW) face a growing crisis marked by high burnout levels (40-60%) and a rising intent to leave the profession. Current interventions focus mainly on individual resilience but have limited collective impact. Emerging evidence suggests that “Moral Injury” (MI)—a deep discord between HCW values and their practice, often worsened by organizational and economic constraints—may play a key role in this crisis.

The primary aim of this study was to describe the manifestations of MI among HCW in France, with a healthcare system characterized by universal health coverage. Secondary objectives included the psychometric validation of the Moral Injury Inventory (MII) for HCW, analysis of organizational determinants of MI, and modeling of the underlying mechanisms of this phenomenon.

This cross-sectional, observational study was conducted nationally via an online survey. Measures included the MII, the Moral Injury Events Scale (MIES), the PHQ-9 for depression, the GAD-7 for anxiety, the Maslach Burnout Inventory (MBI), and the EuroQol 5-Dimensions (EQ-5D) for quality of life. Item Response Theory (IRT) was used to test the MII, including assessments of construct validity, and reliability. Structural equation modeling (SEM) was used to explore complex interactions between MI and other variables, including burnout, depression, and anxiety.

Nearly 3,000 HCW participated in the survey. Psychometric analysis confirmed that the MII met IRT model assumptions, including unidimensionality, local independence, and monotonicity, with fit indices indicating adequate model fit (RMSEA ≤ 0.08, CFI, TLI ≥ 0.95, and infit mean square statistic ranging between 0.7 and 1.0). Differential Item Functioning analysis revealed no item biases. Over 50% of HCW reported experiencing MI, with notable variability across structural/organizational characteristics. MI and burnout emerged as distinct yet frequently associated constructs, with moderate to strong correlations observed between them. Their combined presence had a cumulative negative impact on health outcomes, with affected HCW showing higher levels of depression, anxiety.

This study highlights the high prevalence of MI among HCW in France, even within a robust healthcare system with universal coverage, and confirms that MI is distinct from burnout. These findings underscore the need for systemic interventions that address organizational factors, beyond the current individual-focused approaches used for burnout. Such a shift in focus would also help move away from the current tendency to over-burden and even blame HCW for systemic issues beyond their control. Given the global nature of the healthcare crisis, an international study is essential to identify systemic factors across healthcare settings, paving the way for a holistic, worldwide approach to supporting the healthcare workforce.

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In transforming mental health care, integrating patient perspectives is essential through Patient-Reported Experience Measures (PREMs) and Patient-Reported Outcome Measures (PROMs). PREMIUM and MyPsy&I® are two French initiatives advancing this approach by developing adaptive PREMs and PROMs and implementing a digital platform for seamless data collection, fully integrated within France’s national health information systems.

The objectives were (1) to develop eight item banks (seven PREMs and one PROM) and their corresponding Computerized Adaptive Tests (CATs) using a rigorous methodology grounded in Item Response Theory (IRT) (PREMIUM); and (2) to create a digital platform designed for multi-level use (micro, meso, and macro), enabling integration within the national health information system for enhanced patient feedback collection and analysis (MyPsy&I®).

This multicenter, cross-sectional study uses a mixed-methods approach, integrating qualitative and quantitative methodologies across three main phases: (1) development of item banks and corresponding CATs based on a standardized procedure, including conceptual work, domain mapping, item selection, item bank calibration, and CAT simulations and validation; (2) development of a digital platform tailored for multi-level use and integrated within the national health information system; and (3) a qualitative study exploring the implementation and acceptability of both the CAT and the digital platform.

More than 3,000 patients with schizophrenia, bipolar disorder, and major depressive disorder were recruited from various inpatient and outpatient settings in France.

Unidimensionality, local independence, and monotonicity were verified for each item bank. Psychometric properties were satisfactory for both internal (RMSEA ≤ 0.08, CFI, TLI ≥ 0.95, and infit mean square statistic ranging between 0.7 and 1.0) and external validity. Each CAT demonstrated satisfactory accuracy and precision (standard error of measurement < 0.55 and root mean square error < 0.3), with an average administration of eight items.

The MyPsy&I® digital platform has shown strong acceptability and value across 12 French hospitals, facilitating efficient, real-time collection of patient feedback. This streamlined approach allows healthcare providers to integrate patient perspectives at various stages of care, enhancing both the quality and responsiveness of mental health services.

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This work provides adaptive PREMs, PROMs, and a digital platform that streamline patient feedback collection, reducing burden on patients and providers. Integrating these tools into the health information flow is essential for embedding patient perspectives in modern healthcare systems, especially in a digital and AI-enhanced environment.

None Declared

Access to genetic testing and counseling for infertile couples is essential to provide them specialized care at the genetic level. Having access to psychological support during genetic fertility assessment can be very helpful for many patient and genetic counseling offers invaluable emotional support throughout the process.

Based on our twenty-four years’ experience in genetic counseling, we present here the main psychological challenges facing couples struggling with fertility problems.

We selected all infertile couples evaluated between 2000 and 2024, who were treating their infertility with assisted reproductive technologies. Patients’ psychological problems and emotional suffering, as well as the causes of these conditions, were evaluated retrospectively through our genetic counseling reports.

All couples suffering from primary infertility show a more obvious decline in general well-being and satisfaction as a couple, when they are compared to couples seeking ART for secondary infertility, but having already other children. Anxiety, depression and feelings of culpability in infertile partners are the most common psychological concerns. Besides the psychological distress related to infertility, ART itself is, despite the hope it offers in terms of parenthood prognosis, a stress factor and a cause of numerous emotional and psychological problems. This distress is related to the invasive features of the ART, such as intra-testicular sperm extraction in azoospermic men and oocyte puncture, and the hormonal use in the female partners, which disturb their behaviors and moods. Other problems are associated with the lengthy, arduous and economically burdensome procedures involved in the entire treatment process. In addition, the worries of failure and the distress of failure when it becomes a reality are a crucial factor in psychological distress for the couple. Furthermore, dissatisfaction and frustration when ART is undergone for infertility affecting only one partner were noted. Many religious issues and worries about fear or phobia concerning germ cell manipulation also contribute to psychological problems. Genetic testing is another burden for the couples in our study, given the widespread ignorance of genetics and the consequent phobia of the unknown, as well as the fear of results that, once revealed as abnormal, will affect self-esteem for life.

This study describe the psychological concers of infertile couples undergoing ART treatment in the Tunisian Context. The improvement of the understanding of psychological needs, which are certainly provided during genetic counselling, requires a multidisciplinary consultation, involving gynecologist, reproductive biologists, geneticists, psychiatrists and psychologists. This would enable holistic and personalized psychological intervention and support.

None Declared