Sexual function is essential to women’s health, impacting psychological well-being and relationships. In Tunisia, cultural norms may influence how sexual dysfunction is reported and perceived. This study examines the prevalence of sexual dysfunction and its psychological consequences.

To evaluate sexual function in Tunisian women and assess its correlation with psychological distress.

This cross-sectional descriptive study was conducted in March 2023 with 80 Tunisian women, aged 24-50, using a self-administered online questionnaire. Data collection involved the Female Sexual Function Index (FSFI) to assess sexual dysfunction and the Depression Anxiety and Stress Scale (DASS-21) for psychological well-being. Key sociodemographic variables, including marital status, number of children, and socio environmental context were also collected.

We gathered data from 80 women out of 500 distributed questionnaires (16%).

Participants had a mean age of 33.35 years. A majority (63.7%) had children, and 93.8% resided in urban areas. Notably, the majority of women who responded to the questionnaire (74%) were married.

Among the study population, the median FSFI score was 23.65, with 61.3% scoring below the threshold of 26.55, indicating sexual dysfunction. For married women (n=59), the mean FSFI score was 23.7 ± 7.9. The detailed FSFI scores for the entire population and married women are presented in Table I, indicating that the most affected domains of sexual function were excitation and desire. Severe depression, anxiety, and stress were reported by 6.3%, 12.5%, and 6.3% of participants, respectively.

Sexual dysfunction was significantly associated with depression (p=0.02). However, no statistically significant associations were found between anxiety, stress, and sexual dysfunction.

Table I: FSFI Scores among the Study Population

The study shows a high prevalence of sexual dysfunction among Tunisian women, tied to psychological distress, mainly depression. Enhancing sexual health and mental well-being is key to improving overall quality of life and addressing marital issues. Future research should explore culturally sensitive interventions to enhance sexual health and support women’s mental well-being.

None Declared

We represent a case report of a female patient with schizophrenia and gender identity disorder, shedding light on the complexity of her medical condition. The patient gave the informed consent for anonymous presentation of her case.

We want to highlight the unique vulnerability of schizophrenia patients with comorbid gender identity issues. The diagnostic and treatment processes of these patients should be insightful, careful and interdisciplinary.

Descriptive report of a case report based on the regular examination of the patient, review of patients clinical file and a non-systematic literate review.

The 23-year-old female patient, diagnosed with undifferentiated schizophrenia at the age of 18, has been receiving regular one-monthly therapy with aripiprazole long-acting injection since 2019. The psychosis has been in stable remission since 2019. Due to comorbid mixed anxiety and depressive disorder, she was receiving sertraline. In 2021, the patient identified as a transgender male. He was admitted to outpatient clinic for sexual health, where he was diagnosed with gender identity disorder. In February 2023, the patient started receiving testosterone transdermal gel due to the recommendation letter of the Slovenian interdisciplinary team for gender identity confirmation. Three months later, he reported insomnia and strong intrapsychic tension; intense hands tremor was also observed. He was voluntarily admitted to the psychiatric clinic due to suspected psychotic symptoms.

Before prescribing hormone therapy to the patient in our case, the psychotic background of his desire for gender reassignement was excluded by multidisciplinary team. Due to suspected relaps of schizophrenia, which appeared three months after the patient had started receiving testosterone treatment, the Slovenian interdisciplinary team for gender identity confirmation reconsidered the patient’s case and decided to temporarly discontinue his testosterone hormone therapy. The patient continues with his psychiatric treatment.

It is important to notice that exacerbation of psychotic symptoms in the course of schizophrenia may prevent implementation of various stages of treatment of gender dysphoria. Hormonal pharmacotherapy can affect the patients emotional state. The use of pharmacological and surgical methods used for gender reassignment should be precluded in the case of current psychotic process. Treatment of gender dysphoria should be conducted in accordance with current version of the World Professional Association of Transgender Health standards.

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Sexuality is a central aspect of human life, encompassing its complexities and diversities. In the field of Psychiatry, Paraphilic Disorders remain a subject of ongoing controversy, including debates over the definition of paraphilia itself.

The present work aims to present a review of the current state of the art regarding the evolution of Paraphilic Disorders, analyzing the evidence that supports this diagnosis, and promote the importance of evolution, understanding and non-stigmatization of sexualities.

Evidence-based review, using a PubMed research and selection of the most relevant studies on this topic, published in the last decade.

An evolution was evident in the classification systems, where initially a pathologization of non-normative sexual practices predominated. Homosexuality and masturbation were understood as diseases, and as such susceptible medical and social control.

In DSM III, the concept of paraphilia, sexual arousal outside normal activity patterns, was introduced in an attempt to reduce stigmatization. But only in DSM V was the distinction made between Paraphilia and Paraphilic Disorder, the latter as causing suffering or dysfunction to the individual or others. This distinction marked a change in paradigm.

The definition and categorization of Paraphilic Disorders in the main classification systems has been influenced by changes in sexual and social norms over time, highlighting their influence on the recognition and treatment of paraphilias.

The view of human sexuality continues to be deeply marked by heteronormativity and reproduction as a social and cultural model, causing sexual practices outside this standard to be labeled as pathological. These diagnoses tend to focus on specific behaviors rather than considering the complexity of each person’s sexual experiences, and to be based on prejudices and stereotypes rather than robust scientific evidence.

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Sexuality, although an essential component of human health, remains a controversial topic, shrouded in stigma, particularly in the context of dementia, where the expression of sexuality presents unique challenges.

The main objective of this work is to address the complexity of the biopsychosocial components of sexuality in patients with dementia, promoting a change in medical perspective and social attitudes.

Evidence-based review, through research conducted on PubMed and selection of the most relevant studies on this topic, published in the last decade, using the keywords: “Sexuality” and “Dementia”.

Cognitive impairment can affect the frequency and satisfaction with sexual activity. Most studies focuses exclusively on the biological (and dysfunctional) component of sexuality, devaluing the challenges and barriers to the expression of this sexuality. The deterioration of cognitive processes, with emphasis on the involvement of the prefrontal cortex, can influence the ability to make decisions, setting boundaries and providing consent. Inappropriate sexual behaviors, such as disinhibition and hypersexuality, have an incidence of 7-25% in patients with dementia, and may require intervention psychopharmacological. These vulnerabilities result in an enormous challenge in terms of establishing a balance between autonomy and safety of these patients, sometimes resulting in neglect of sexual health in treatment environments.

A comprehensive understanding of the sexuality of older adults with dementia is essential to improve the quality of life and clinical care of this population, highlighting the importance of accurate education and inclusive sexual orientation, creating safe spaces for dementia patients to explore and express their sexuality.

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The perinatal period, encompassing pregnancy and the first postpartum year, is a transformative phase in a woman’s life. It involves profound physical, psychological, social, and emotional changes that can significantly impact sexual experiences.

The purpose of this work is to address the challenges of experiencing sexuality during the perinatal period.

Evidence-based review, through research conducted on PubMed and selection of the most relevant studies, published in the last decade, using the keywords: “Sexuality” and “Perinatal period”.

Hormonal fluctuations, physical discomfort, and body image changes during pregnancy can significantly affect sexual desire and satisfaction. By the third trimester, between 83 to 100% of first-time mothers report a decrease in sexual activity. Recent studies indicate that this trend continues into the first postpartum year, with over 60% reporting decreased sexual activity. Postpartum challenges, such as physical recovery, breastfeeding, and fatigue further complicate sexual intimacy. The anticipation of parenthood and shifts in relationship dynamics also play a significant role. Societal pressures and cultural norms regarding sexuality in the perinatal period can influence personal experiences and expectations, and contribute to communication barriers between partners regarding sexual needs and concerns.

The perinatal period presents unique challenges to sexual health and intimacy. A holistic perinatal care, incorporating comprehensive sexual health education and promoting open communication between partners are crucial for addressing these challenges effectively.

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Pedophilic disorder is characterised by a sustained, focused, and intense pattern of sexual arousal involving pre-pubertal children. In addition, the individual must have acted on these thoughts, fantasies or urges or be markedly distressed by them (ICD - 11).

Beyond its obvious ethical and legal implications, this disorder is often associated with substantial mental health comorbidities, including depression, anxiety, and substance abuse. One particularly alarming yet understudied aspect is the elevated risk of suicidal ideation and behavior among individuals diagnosed with pedophilic disorder. The intersection between pedophilic disorder and suicide risk is critical to understand, as it can inform the development of more effective intervention strategies and support systems.

The present review aims to explore the intersection between pedophilic disorder and suicide risk, shedding light on the psychological factors that contribute to suicidal ideation and behavior among individuals with this disorder, including those who have never sexually engaged with children.

PubMed, Web of Science and Google Scholar were searched using the following keywords “pedophilic disorder”, “suicide risk”, “suicidal ideation”, and “stigma”. Articles published within the last decade were included.

The review showed several risk factors, perhaps the most significant being the psychosocial effects of the intense stigma, social isolation, and internalized shame. Other risk factors are prior mental health treatment, weaker attraction to adult women, history of sexual abuse, young age, less education, and additionally, the lack of access to appropriate mental health services.

The relationship between these individuals’ emotional distress and their likelihood of sexually engaging with a child is not known, but there is evidence that impulse control is compromised by negative affect. Moreover, literature posits that stigma raises the risk of sexual activity with children via disturbances in emotional, social, cognitive, and health service utilization domains.

It is evident that this population faces unique challenges that require specialized attention and addressing this intersection necessitates a comprehensive approach.

Strategies aimed at reducing stigma, promoting social support, enhancing access to mental health services and fostering supportive environments have the potential to mitigate suicidal risk factors and enhance overall well-being. Furthermore, efforts to destigmatize help-seeking behaviors and improve access to confidential and non-judgmental support services are crucial in reducing the incidence of suicide and promote mental health among this population.

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Gender dysphoria (GD) refers to the marked incongruity between the experience of one’s gender and the sex at birth.

Psychiatric illness is one of the major negative prognostic features for the outcome of GD. In particular, much controversy exists regarding whether individuals with psychotic symptoms should receive gender affirmative treatment.

The present review aims to provide an overview of the current literature of the occurrence of gender dysphoria symptoms during psychotic episodes and identify challenges in differential diagnosis and treatment and offering recommendations to overcome them.

Articles published on the last five years were searched on Medline, PubMed, Web of Science and Springer Link using the following keywords: gender identity, psychosis, gender dysphoria.

Delusions about one’s physical appearance and the desire to change the body can be observed in patients with schizophrenia or other psychotic disorders. Therefore, the differential diagnosis is critical for therapeutic planning and effort is required to carry out the necessary diagnostics when articulation of gender dysphoric feelings coincides with the onset of psychosis. It is crucial to evaluate the chronology and dynamics of the individual symptoms, their constancy, patient’s criticism, and response to antipsychotic treatment.

Some presentations of GD can be created by life experience in individuals who have underlying mental or neurophysiological abnormalities. The experiences of practitioners indicate that coincidence of schizophrenia and gender identity disorder is possible, that is why the differential diagnosis needs time, careful observation, examination and cooperation of psychiatrist and sexologist.

This review addresses the significance of understanding each patient’s individual circumstances, focusing specifically on proper physician training and direct patient care.

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In Spain, erectile dysfunction (ED) affects around 19% of men aged 25 to 70, with higher prevalence in older age groups. Family doctors are key for early ED detection, yet it is often underdiagnosed due to limited sexual health training and poor communication. Many patients hesitate to discuss sexual issues, and short consultation times worsen this problem. Early diagnosis is crucial for effective intervention, improving both quality of life and health outcomes.

To evaluate the effects of chronic diseases and medications on ED and identify commonly used treatments.

This retrospective review focused on patients with late-diagnosed ED. We assessed the delay in reporting symptoms and contributing factors such as embarrassment and consultation constraints. The study also explored the impact of chronic conditions like diabetes and hypertension, and the role of psychotropic medications. Data were gathered from the Sexology Patient Database at Vallirana Primary Care Centre (CAP), covering 255 sexual dysfunction cases. The review aimed to understand diagnostic delays and the influence of chronic conditions and medications on ED.

Of 255 sexual dysfunction diagnoses, 193 were ED, making up 75.69%. The average patient age was about 62, with an average delay of 1.95 years before seeking help. ED comorbidities included Cardiovascular and Metabolic Diseases: 33.3%, Musculoskeletal and Articular Diseases: 31.25%, Psychiatric and Sleep Disorders: 29.2%, Digestive Diseases: 20.83%, Respiratory Diseases: 18.75%, Urogenital Disorders: 18.75%, Dermatological Disorders: 12.5%, Neurological Disorders: 10.42%, Endocrine Disorders: 8.33%, and Harmful Habits: 8.33%. Common medications were Antihypertensives: 16.7%, SSRIs: 14.6%, Proton Pump Inhibitors: 12.5%, Benzodiazepines: 10.4%, Antidiabetics: 10.4%, Statins and Fibrates: 10.4%, Bronchodilators and Inhaled Corticosteroids: 10.4%, Antiplatelets: 8.3%, and Other Medications.

The high ED prevalence of 75.69% underscores major issues with timely diagnosis. The average 1.95-year delay highlights barriers to early treatment. Chronic conditions, especially cardiovascular and metabolic disorders, are closely linked to ED. The presence of psychiatric and sleep disorders indicates a complex interaction with sexual dysfunction. The variety of medications used, particularly antihypertensives and SSRIs, necessitates careful management to avoid adverse effects. Family doctors are crucial for diagnosing, managing ED, and referring to specialists. However, time limitations and lack of sexology training often result in underdiagnosis. Enhancing awareness can improve early detection and management, leading to better patient outcomes and timely specialist care.

None Declared

Serotonergic antidepressants, particularly Selective Serotonin Reuptake Inhibitors (SSRIs), have been known to cause relevant sexual adverse effects, which were originally thought to disappear after treatment course. In later years, an emergent condition concerning the persistence of sexual impairment following SSRI discontinuation has gathered increasing social and scientific interest. Post-SSRI sexual dysfunction (PSSD) is still underrecognized and understudied.

Our aim was to gather available evidence regarding the pathophysiological mechanisms and contributing factors to PSSD, as well as current management options.

A literature review was conducted using PubMed, through research of the following MESH terms: “Selective Serotonin Reuptake Inhibitors”, “Antidepressive Agents”, “Sexual Dysfunction, Physiological” and “Sexual Dysfunctions, Psychological”. Only papers published in English were included.

PSSD has been described as an iatrogenic condition whose symptoms could persist indefinitely. Despite clinical heterogeneity and lack of robust literature surrounding PSSD, there is growing evidence of this concern. In order to diagnose PSSD, sexual dysfunction due to reemergence of depressive illness must be ruled out. Accurate incidence and prevalence rates of this condition are unknown, though it appears to be a rare phenomenon. Several potential etiological explanations for PSSD have been proposed. Some have highlighted a dysregulation in serotonergic activity induced by SSRIs, while others have tested the role of neuroregulatory agents and bioelectric circuits. Another theory involves a possible link between PSSD and other post-discontinuation syndromes. In contrast, some authors have theorized that sexual impairment induced by a long course of SSRIs could induce a negative conditioning effect towards sexual activity in some patients. Despite abovementioned hypotheses, sexual dysfunction is usually complex in nature and thus multifactorial. There is no established treatment to PSSD. Pharmacological and psychotherapeutic approaches have been tested and proposed to ameliorate symptoms of PSSD, but further investigation is warranted.

PSSD is a heterogenous and idiosyncratic syndrome that needs further characterization. It remains unclear why only certain individuals develop PSSD and treatment options are limited. Current evidence is still incipient and insufficient to justify adjusting current SSRI prescription patterns. However, clinicians must be aware of this condition and should monitor and address these issues with patients. Future research should provide further insights into underlying pathophysiological mechanisms, which in turn could help acknowledge possible preventive and therapeutic interventions.

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The phenomena of regret and detransition in individuals undergoing gender-affirming treatments raise significant medical and bioethical challenges for professionals working in this area.

This work aimed to gather the most current evidence regarding the approach to the issues of regret and detransition, characterizing the main factors involved and reflecting on possible prevention strategies.

A literature review was conducted through research on PubMed, using the keywords “gender dysphoria,” “regret,” and “detransition”. Only articles in English were included. Additional bibliography was selected by consulting the references of the initially included articles.

Regret and detransition are distinct concepts. In fact, there can be regret without detransition and detransition without regret, with the narratives and experiences of these individuals being very diverse. Detransition may be motivated by external or internal factors, depending on whether transgender identity is preserved or lost. Originally thought to be rare, it has been challenging to assess the actual prevalence of these phenomena, whose increase is expected in the future. In an effort to counter this trend, the literature emphasizes the importance of a multidisciplinary and comprehensive approach to individuals with gender dysphoria, based on effective and assertive communication, ensuring responsible and informed decision-making. Regular follow-up combined with psychosocial support throughout the entire transition process is also crucial. Therapeutic approach should be individualized and integrated into a continuing care plan, grounded in an empathetic and non-judgmental attitude.

Regret and detransition are not necessarily synonymous with medical error. Considering the complex spectrum of experiences involving these phenomena, a comprehensive approach that allows for an integrated view of each person and their needs is essential. Further research and development of guidelines regarding the approach and support for this group of individuals are needed.

None Declared

Erectile dysfunction (ED) is a multifactorial condition affecting a significant propotion of men worldwide, impacting their mental well-being, life quality and interpersonal relationships. Often associated with various underlying factors, ED manifests differently in each individual, yet there is a limited understanding of the unique profiles of specific populations, such as military veterans, who may face distinct physical, psychological and social challenges contributing to the condition.

This study aimed to explore the clinical profile, demographic factors, and associated comorbidities of Tunisian military veterans affected by ED.

A cross-sectional descriptive survey was conducted between September and November 2024 on Tunisian veterans seeking consult, using a data file and 2 self-report scales:

The Hospital Anxiety and Depression (HAD) scale, consisting of two subscales: Anxiety (A) and Depression (D), dividing patients into: normal[0-7], borderline case[8-10], an abnormal level of anxiety or depression[11-21].

The IIEF-5 (International Index of Erectile Function 5) to evaluate ED with six categories: [1-4]: uninterpretable, [5-7]: severe, [8-11]: moderate, [12-16]: mild to moderate, [17-21]: mild and [22-25]: no ED.

The study enrolled 28 veterans diagnosed with ED, with an average age of 40 [25-61] years. Most (78.6%) were married while 17.9% were single and 3.6% were divorced.

Smoking was prevalent in 82.1% and 21.4% reported alcohol consumption, with 83.3% drinking occasionally and 16.6% drinking regularly. None reported using cannabis or other illicit drugs.

Regarding medical history, 39.3% had medical health conditions including varicocele, diabetes, combined arterial hypertension and diabetes, myocardial infarction and other health issues.

Psychiatric follow-up was reported by 85.7% of the individuals.

Anxiety symptoms were present in 89.3% of participants with 3.6% classified as borderline cases. Depressive symptoms were reported by 67.9% with 21.4% categorized as borderline symptoms.

Notably, 64.3% of the veterans experienced both anxiety and depressive symptoms and were taking antidepressants, while only one veteran exhibited neither. The remaining had either anxiety or depressive symptoms.

In terms of ED severity, 46.4% had mild to moderate ED, followed by 28.6% with mild ED, 17.9% with severe ED and 7.1% with moderate ED.

Only 14.3% reported using sexual enhancers.

This study provides valuable insights into the unique profile of ED among Tunisian veterans, revealing a high prevalence of psychological comorbidities, particularly anxiety and depression, alongside physical health issues. The interconnection of these factors highlights the importance of a holistic approach adressing both psychological and physical aspects of ED. These results call for further research into the specific challenges faced by veterans for a more personalized and effective interventions.

None Declared

Systemic Lupus Erythematosus (SLE) is a systemic disease that can significantly impact women’s lives. Female sexual function is one of the underestimated areas, and few studies have focused on sexual dysfunctions in women with SLE.

To study the sexuality of patients with SLE, the factors associated with it, and the relationship with the disease activity stage.

A descriptive and analytical cross-sectional study was conducted with 38 patients with SLE followed in the internal medicine department at Hedi Chaker University Hospital, Sfax, over a period of 3 months from September to November 2023. We used:

A socio-demographic and clinical data sheet, and the SLEDAI scale for assessing disease activity criteria.

The Female Sexual Function Index (FSFI) scale to study sexuality over the past 4 weeks.

The average age of the patients was 46.63 ± 10.21 years. Among them, 36 were married, and 44.7% had medical-surgical history.

The average age at SLE diagnosis was 37.11, with an average disease duration of 8.95 years. The mean SLEDAI score was 3.63. Absent to moderate activity was present in 92.1% of cases, and high activity in 7.9%.

Photosensitivity was noted in 36.8%, joint involvement in 63.2%, and anemia in 52.6%. Among the patients, 86.8% were on corticosteroids and 26.3% on immunosuppressants.

The average age of onset for sexual difficulties (SD) was 37.28 years, with an average delay of 3.05 years from disease onset.

According to FSFI: the mean score was 58.38 ± 23.412 [2 - 93]. A decrease in overall sexuality was noted in 44.7%, desire in 63.2%, satisfaction in 57.9%, arousal in 52.6%, and lubrication in 39.5%.

The factors correlated with different FSFI domains were:Desire: associated with medical-surgical history (P=0.001), photosensitivity (P=0.028), and anemia (P=0.003). Sexual satisfaction: associated with medical-surgical history (P=0.011), joint involvement (P=0.034). Arousal: associated with medical-surgical history (P=0.01) and anemia (P=0.004).

There were no statistically significant correlations between the disease activity stage and the different FSFI domains. However, the onset of SD was shortened if use of corticosteroid (P=0.005) or immunosuppressive treatment (P=0.038).

Our results indicate that SLE can impair sexuality in various domains, especially if associated pathologies are present. Therefore, special attention should be given to the sexual function of patients with lupus.

None Declared

Hemodialysis, although crucial for maintaining the survival of patients suffering from end-stage renal disease, can have severe repercussions on patients’ overall quality of life and sexuality.

To determine the prevalence and factors associated with sexual dysfunction in hemodialysis patients.

This is a multicenter, descriptive, cross-sectional study with analytical aims, conducted at 3 hemodialysis units (the Mahmoud El Matri Hospital in Ariana, the El Manzah private hemodialysis center and the El Omrane polyclinic) over a 5-month period (August-December 2023). Patients’ sexual dysfunction was assessed using the IIEF5 scale.

Our study population comprised 73 patients. Patient ages ranged from 25 to 86 years, with a median age of 56.87 years. Twenty-eight subjects (38.4%) were between 56 and 70 years of age. Sixty patients (82.2%) were married, with 68 living with relatives. Regarding anamnestic data, organic comorbidity was found in all patients with diabetes in 67.1% and arterial hypertension in 50.7% of cases. The median duration of hemodialysis was 48 months. The frequency of hemodialysis sessions was 3 per week in 69 patients (94.5%).

Erectile dysfunction was diagnosed in 64 patients, corresponding to a prevalence of 87.7%. The dysfunction was mild in 24.7% of cases, moderate in 45.2% and severe in 17.8%.

Erectile dysfunction was significantly correlated with age over 55 with an adjusted OR = 2.43 and the presence of diabetes with an adjusted OR = 1.5.

The prevalence of erectile dysfunction is high in hemodialysis patients. A systematic sexological approach is needed to ensure early and appropriate management.

None Declared

In the high-stress world of healthcare, the intertwined relationship mental health and the life quality is pivotal.

Prioritizing healthcare professionals’ mental health and nurturing a positive safety climate are essential to enhancing overall job satisfaction.

Evaluate the mental health status of the physiotherapists.

his is a cross-sectional study among Physiotherapists (PTs) working in the city of Sousse. A self-administrated questionnaire was distributed either manually or via e-mail to collect information about the personal and occupational history of participants. The mentel health was assesed by the the mental component score (MCS-12) of the the Short Form Survey SF-12.

A total of 93 questionnaires were collected. The PTs were 35±8 years old on average. Women made up 65.6% of the PTs. Sixty-six (71.7%) and sixty-two (67.4%) did not provide any medical or surgical history respectively and the majority of the population (54.5%) had a normal BMI. Among all respondents, nineteen (20.4%) PTs were regular smokers and an alcoholic beverage was consumed by 14 (15.7%) PTs. The sport was the common hobby of PTs (53.8%). In this group of PTs, 37 (40.2%) worked in the public sector, and 55 (59.8%) worked in the private sector. The mean seniority was 11.9±7.8 years and the average workweek for the population was 42.42 hours. The mean MCS-12 score was 43.94 (9.05 SD). The findings showed that 35 PTs (37.6%) had MCS-12 scores below the standard value. Male PTs showed slightly higher MCS-12 means than female PTs with a modest difference between PTs working in the public and private sectors. PTs who had more than 15 years of work experience scored the lowest MCS-12 mean 41.40 (SD 9.94) which is a score underneath the reference value indicating in this case low mental health functioning among PTs.

This study showed that Tunisian PTs had low mental health statuts highlighting the need for approaches to improve interventions that effectively enhance well-being, retention, and sustainability of practitioners, and thus the care delivered, in the healthcare system

None Declared

Despite global movements to combat Sexual harassment (SH), it continues to affect individuals in various professions, with medical residents and interns being particularly vulnerable.

To explore the prevalence of SH among medical trainees in Sfax, Tunisia.

To evaluate the consequences of SH on this group and factors related to SH.

We conducted a cross-sectional and descriptive study involving medical residents and interns working in hospitals in Sfax. Data were collected using an anonymous self-questionnaire. This questionnaire was published on social media during January and February 2024. It included sociodemographic characteristics, psychiatric and medical history, psychoactive substance use, professional data, information related to sexual life and experiences related SH.

We collected 141 responses, of which 19.9% declined to participate in this study.

Finally, a total of 113 participants, with an average age of 27.92 years, were recruited. The sex ratio (M/F) was equal to 0.54. In our population, 20.4% were interns. Among the participants, 68.1% were single, 91.2% were from urban backgrounds and 12.4% had psychiatric follow-up. Among the participants, 41.6% reported experiencing sexual harassment during their practice at the hospitals in Sfax. The most common form self-reported as harassment was verbal harassment (43.3%).

In our study, most victims of sexual harassment (SH) tried to ignore (36.2%) and avoid (34%) the harasser. Some participants noted that they were afraid of career repercussions.

Regarding the consequences of SH, sleep disorders and the feeling of burnout were the most frequently reported medical effects, with a prevalence of 10.6% in both cases. Additionally, the onset or increase in tobacco consumption (8%) was the most commonly reported addictive consequence.

On a sexual level, 16 participants (14.2%) reported experiencing negative impacts on their sexuality. Sexual desire disorders (8.8%) were the most frequently reported sexual consequences, followed by a decrease in sexual satisfaction (2.7%).

In our survey, SH was statistically more prevalent among female participants (p <0.001) and among participants with a low or middle socioeconomic status (p = 0.036).

These results highlight the urgent need for hospitals to implement preventive measures, support victims, and promote a safer working environment for medical trainees.

None Declared

Sexual harassment (SH) is defined as any form of pressure aimed at obtaining a sexual act, for the benefit of the perpetrator or a third party. Despite movements aimed at combating sexual harassment, it remains a complex and concerning reality, particularly in the workplace. Unfortunately, the hospital environment is not spared from this issue. Medical residents and interns seem to be the population most affected by the SH.

To estimate the prevalence of SH among medical residents and interns.

To describe the profile of SH’s victims and examine their perceptions regarding sexual education.

We conducted a cross-sectional and descriptive study involving medical residents and interns working in hospitals in Sfax. Data were collected using an anonymous self-questionnaire. This questionnaire was published on social media during January and February 2024. It included sociodemographic characteristics, psychiatric and medical history, psychoactive substance use, professional data, information related to sexual life and experiences related SH.

We received 141 responses, of which 19.9% declined to participate in this study. Ultimately, 113 participants, with an average age of 27.92 years, were included in the final analysis. The sex ratio (M/F) was equal to 0.54. In our population, 20.4% were interns. Among the participants, 68.1% were single, 91.2% were from urban origine and 12.4% had psychiatric follow history for anxiety disorders, depression, obsessive-compulsive disorder, and bipolar disorder (n= 8, 2, 2, and 1, respectively).

Among the participants, 41.6% reported experiencing sexual harassment during their practice at the hospitals in Sfax. The most common form reported as harassment was verbal harassment (43,3%). The majority of SH perpetrators were male (87.2%), and 27.6% were senior physicians. According to our study, 8.5% of the SH perpetrators were sanctioned for their actions, and 80.5% of SH victims believed that the perpetrators had continued to exhibit such behavior.

Regarding sexual education, 80.5% of participants thought that it was necessary in school curriculums, with thirty-seven participants believing they had received adequate sexual education.

This study highlighted the high prevalence of sexual harassment among medical trainees in Sfax. These results serve as an urgent call to the development of effective strategies to prevent sexual harassment in hospital environments and highlight the importance of raising awareness among staff about available legal protections.

None Declared

Sexual harassment (SH) is a pervasive issue, particularly in workplace environments. The medical field, especially in hospitals, is not immune to this issue with medical residents and interns often being disproportionately affected. SH can have profound psychological, emotional, and physical consequences, which can impair professional performance and well-being.

To assess the psychological impact of SH among medical residents and interns working in hospitals in Sfax Tunisia.

We conducted a cross-sectional and descriptive study involving medical residents and interns working in hospitals in Sfax. Data were collected using an anonymous self-questionnaire. This questionnaire was published on social media during January and February 2024. It included sociodemographic characteristics, medical history, psychoactive substance use, professional data, and experiences related SH. The Depression Anxiety Stress Scale (DASS-21) was used to assess the psychological distress of the participants.

We collected 141 responses, of which 19.9% declined to participate in this study.

Finally, a total of 113 participants, with sex ratio (M/F) of 0.54, were recruited. The average age was 27.92 years. In our population, 20.4% were interns. Among the participants, 68.1% were single, 91.2% were from urban backgrounds.

Among the participants, 41.6% reported experiencing sexual harassment during their practice at the hospitals in Sfax. Verbal harassment was the most common form reported as sexual harassment (43,3%). The assessment of the DASS21 questionnaire showed, that 17 participants had a moderate overall score (15%) and seven participants had a severe overall score (6.2%). In our study, the overall DASS scores (p<0.001), as well as the Depression (p<0.001), Anxiety (p<0.001), and Stress (p=0.002) sub-scores, were significantly higher among participants who were victims of harassment.

The findings underscore the urgent need for implementing preventive measures in hospital settings, providing support for victims, and raising awareness about SH and its consequences.

None Declared

Female sexual dysfunction (SD)has gained attention in recent years. Multiple factors contribute to women’s sexual vulnerability, including neurobiological, sociocultural, psychological, and interpersonal factors.

To assess the prevalence of SD and to determine sociodemographic and clinical factors related to this dysfunction.

We conducted a cross-sectional and descriptive study including married and sexually active female medical residents from different specialties.Data were collected using a self-questionnaire published by GOOGLE FORMS. The questionnaire included sociodemographic characteristics, substance use, marital life information, professional data, and information related to sexual life. Female Sexual Function Index (FSFI) was used to assess female sexual dysfunction.

A total of 65 medical residents completed the online questionnaire. Four residents (6.20%) considered the work environment to be unfavorable, 3.1% were smokers and 55.4% had children. The average frequency of sexual intercourse was 6.61 ± 4.18 times per month. Nine participants (13.8%) reported having sexual intercourse under partner pressure. Sexual dysfunction was observed in 49.2% of the cases. The factors correlated with the total FSFI score were an unfavorable work environment (p=0.02), smoking (p=0.007) and high frequency of sexual activities (p=0.02; r=0.28).The factors correlated with the “Desire” dimension were: sexual intercourse under partner pressure (p=0.002) and high frequency of sexual activities (p=0.001; r=0.41).The factors correlated with the “Arousal” dimension were: an unfavorable work environment (p=0.01) and psychiatric history (p=0.05).The “Lubrication” domain was associated with an unfavorable work environment (p=0.006) and smoking (p=0.02). The “Satisfaction” domain was associated smoking (p=0.004), sexual intercourse under partner pressure (p=0.03) and high frequency of sexual activities (p=0.003; r=0.36). The “Orgasm” domain was inversely correlated with age (p=0.04; r=-2.47), and it was associated with a high frequency of sexual activities (p=0.04; r=0.24). The “Pain” domain was correlated with the presence of children (p=0.02).

The findings underscore the impact of various sociodemographic and clinical factors on sexual health and well-being. Addressing these underlying factors is essential for improving their sexual health and overall quality of life.

None Declared

Dispositional mindfulness (DM), also known as Trait mindfulness, refers to the inherent ability to focus on and sustain attention on present-moment experiences with an open and nonjudgmental attitude. Recent research has increasingly highlighted the positive impact of DM on mental health.

To evaluate the association between DM and sexual dysfunction (SD) among female medical residents.

A cross-sectional online survey, designed using Google Forms, was distributed on social media platforms. We included married and sexually active medical residents. Female Sexual Function Index (FSFI) was used to evaluate female sexual dysfunction. We used the Mindfulness Attention Awareness Scale (M.A.A.S.) to measure the frequency of open and receptive attention and awareness of ongoing events and experiences and the Spielberger State-Trait Anxiety Inventory (STAI-Y-T) to assess anxiety traits.

Sixty-five medical residents with an average age of 29.43 ± 1.95 years completed the online questionnaire. The average age at first sexual intercourse was 25.15 ± 2.34 years and the average frequency of sexual intercourse was 6.61 ± 4.18 times per month.

The mean scores for the M.A.A.S and STAI-Y-T were 26.25 ±5.61 and 45.85 ±9.36 respectively.

The anxiety assessment using the STAI-Y-T scale showed that 30 residents (46.4%) had moderate anxiety, and 8 (12.3%) had high to very high anxiety levels.

The mean total FSFI score was 26.25 ± 5.61 and SD was noted in 49.2% of the cases.

A positive correlation was found between the level of MAAS and the total FSFI score (p=0.003; r=0.35),”Desire” dimension (p=0.02; r=0.28), “Lubrication” domain (p=0.004; r=0.35), and the “Satisfaction” (p=0.006; r=0.33)

Anxiety levels were negatively correlated with the total FSFI score (p<10-3; r=-0.42), the “Desire” dimension (p=0.008; r=-0.32), “Arousal” dimension (p=0.003; r=-0.36), “Lubrication” domain (p=0.002; r=-0.37) and “Satisfaction” domain (p=0.002; r=-0.38).

The results of this study revealed relatively high prevalence rates of SD among medical residents and highlighted several vulnerability factors. Therefore, several measures should be implemented to prevent and determine the factors correlated with SD.

None Declared

The consumption of pornographic products is a phenomenon that continues to increase considerably, especially among young people. It is encouraged by easier access to the Internet. On the other hand the concept of sexual self-esteem is a relatively new and little explored subject in the literature. It has emerged across a range of areas such as weight, sexual trauma and physical satisfaction.

The aim of our study is to evaluate the impact of pornography consumption on sexual self-esteem in a population of Tunisian women and to determine the associated factors influencing this relationship.

This is a cross-sectional, descriptive, and analytical study conducted among 107 Tunisian women.

Data were collected using an anonymous self-questionnaire in French, using Google Forms, distributed across various Facebook platforms. It explored sociodemographic data, medical history and sexual health characteristics, sexual behavior, and pornography consumption along with its impact.

For the evaluation of sexual self-esteem, we used the “Sexual Self-Esteem Inventory for Women - Short Form” (SSEI-W-SF) in French language. (Hannier, S et al. Translation and validation study of the French version of the “SSEI-W-SF”. Sexologies. 2022;31.)

The majority of women (76%) are aged between 18 and 30 years, primarily from urban backgrounds (89%), professionally active (81%). In terms of marital status, 43% are single. Most women (60%) have no psychiatric history, 25% are being treated for anxiety disorders, and 20% for mood disorders. More than a quarter (28%) reported experiencing sexual abuse. Regarding sexual education, majority of women (94%) consider its learning essential, although only 11% received structured education at school. Consequently, 80% of women indicated that their main source of sexual education was online. In the studied population, 60% of women reported consuming pornography, primarily in the form of videos (79%). The evaluation of sexual self-esteem using the SSEI-W-SF revealed an average total score of 61.66, ranging from 26 to 82, with a median of 63 and a standard deviation of 10.887. Women with the lowest scores were particularly affected in terms of adaptability and control. We observed a significant correlation between pornography consumption and the absence of sexual education during childhood (p = 0.009). Women who deemed sexual education essential showed lower consumption of pornography (p = 0.027).

Regarding sexual self-esteem, no statistically significant correlation was found between sexual self-esteem and pornography consumption, either for the global sexual self-esteem score (p = 0.809) or for the five spheres of sexual self-esteem assessed separately.

In conclusion, the influence of pornography on sexual self-esteem warrants careful examination, requiring a balanced perspective that addresses both its positive and negative effects on individuals’ well-being.

None Declared