Paraphilic disorders involve recurrent, intense sexual urges or behaviors toward atypical objects or situations, causing distress or risk to others. Distinguishing them from benign interests or manic sexual disinhibition is often difficult, as both may present with similar symptoms. Misidentifying paraphilic behaviors as mania can lead to major therapeutic errors due to differing treatment approaches.

To illustrate the diagnostic challenges in differentiating paraphilic disorders from manic episodes through a case of multiple paraphilic behaviors initially misdiagnosed as bipolar mania, and to highlight the clinical, therapeutic, and risk-management implications of accurate identification and integrated treatment of multiplex paraphilias.

This study adopts a descriptive single-case design focusing on a 36-year-old male initially misdiagnosed with bipolar mania. Data were collected through clinical interviews, collateral information, and behavioral observation. Diagnostic clarification was guided by DSM-5 criteria and the Young Mania Rating Scale (YMRS), alongside structured risk assessment tools (Risk Matrix 2000/SV, Static-99R). Comorbidities were evaluated using the PHQ-9 and GAD-7. Management combined fluoxetine therapy and cognitive-behavioral interventions.

Reevaluation showed no manic signs but persistent voyeuristic, exhibitionistic, and gerontophilic behaviors, confirming multiple paraphilic disorders. Risk assessments indicated average recidivism. After switching to fluoxetine and initiating cognitive-behavioral therapy, sexual urges decreased and insight improved. This case shows the risk of confusing paraphilias with mania and stresses the value of tailored, multidisciplinary management with pharmacotherapy, psychotherapy, and risk control.

Multiplex paraphilic disorders may resemble affective syndromes when sexual disinhibition predominates. Accurate differential diagnosis is essential to avoid mismanagement. A comprehensive approach combining pharmacotherapy, psychotherapy, and structured risk monitoring ensures better symptom control, reduced relapse risk, and improved patient and public safety.

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The perpetuation of modern myths about sexual aggression (AMMSA) is a barrier to gender equality and effective victim support. Young physicians, as future influencers of public health, are a critical population for studying the determinants of these beliefs.

To identify the sociodemographic factors and sources of information on sexuality associated with a higher adherence to (AMMSA) in a population of young physicians.

We conducted a cross-sectional study among 153 young doctors in Sfax. Data were collected via an online questionnaire (sociodemographic, sexual knowledge sources, French version of the AMMSA scale). Univariate analysis (Student’s t-test, ANOVA and Spearman correlation) was used to compare AMMSA scores across different variables.

The mean global AMMSA score was 102.05 ± 24.67. Male participants had significantly higher scores (114.82 ± 28.13) than females (97.68 ± 21.84), with a p-value <10⁻³.

Participants from rural origin also showed greater adherence to myths (111.5 ± 9.11) compared to urban areas (101.52 ± 25.17, p=0.021). Furthermore, having children was associated with a higher AMMSA score (mean score=111.14 ± 16.78 vs 100.6 ± 25.45, p=0.019). A weak but significant positive correlation with age was also observed (rho=0.176, p=0.03).

Regarding information sources, participants who cited television as a source had significantly higher AMMSA scores (104.8 ± 25.61) than those who did not (95 ± 22.13, p=0.027). Sources such as parents, friends, and the internet showed no significant association.

This study identifies male gender, rural origin, parenthood, and reliance on television as a source of sexual information as key factors associated with a stronger belief in modern myths about sexual aggression. Public health interventions aimed at deconstructing these myths among young professionals should be tailored to target these specific populations and actively counter the misleading narratives often perpetuated by mainstream media.

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Sexuality refers to a wide range of experiences, thoughts, feelings, and behaviors related to sexual attraction, desire, expression, and identity. However, in Tunisia, patients’ sexual concerns are often underestimated due to the reluctance of some healthcare professionals to address sexual health issues. In this context, medical residents, particularly those specializing in psychiatry, are expected to soon be able to practice general medicine in Tunisia and provide appropriate care for their patients.

The objectives of our study were to assess the knowledge of Tunisian psychiatric residents in terms of sexuality, identify their sources of information, and determine the factors associated with their knowledge of patients’ sexuality.

This was a descriptive and analytical study with cross-sectional data collection conducted on a population composed of a sample of psychiatry residents practicing in Tunisia at all levels: from the first to the fifth year. Our study was based on an online questionnaire and assessed participants’ knowledge of sexuality. It took place from March 1 to April 1, 2025.

Forty-two of the 90 psychiatrists approached (47%) agreed to participate in the study and completed the questionnaire. This resulted in a population of 42 young psychiatrists. The majority of psychiatrists participating in the study were female (83%; n=35) with a sex ratio of 5. The average age of these young practitioners was 27.95 years. The majority of participants (31%) were fourth-year psychiatry residents. More than half of the psychiatrists (55%; n=23) had received at least some training in sexology. Workshops and training seminars were the most common form of training (61%, n=27). With regard to knowledge about sexuality, the average percentage of correct answers was 70.73%. Among residents, 31% (N=13) scored 70.73% or higher on correct answers. Regarding factors influencing physicians’ knowledge, we found a significant relationship between the different stages of residency and pharmacological approaches to patients’ sexuality (p=0.001). Furthermore, a significant relationship was found between pharmacological approaches and residents with degrees in sexology (p=0.01). Finally, we found a significant relationship between the knowledge and attitudes of participating physicians toward patients’ sexuality (p=0.045).

This study reveals several gaps in Tunisian doctors’ knowledge and perceptions regarding their patients’ sexuality. At the end of this study, we suggest that sexology be taught in all medical schools in Tunisia and, above all, that the acceptance capacity of residents in such studies be increased. This will promote the good sexual health of our patients and contribute to better mental balance. We also propose the creation of awareness programs for healthcare professionals.

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Sexual health has been defined by the WHO as a state of physical, emotional, mental, and social well-being associated with sexuality. It does not consist solely of the absence of disease, dysfunction, or infirmity. To ensure this state of sexual well-being in patients, medical residents, and specifically those in psychiatry, should have the right attitudes to master the physiological and certain pathological aspects of human sexuality.

The objective of this study was to assess the attitudes of Tunisian psychiatric residents towards sexuality.

This was a descriptive and analytical study with cross-sectional data collection conducted on a population composed of a sample of psychiatry residents practicing in Tunisia at all levels: from the first to the fifth year. Our study was based on an online questionnaire and assessed participants’ attitudes of sexuality. It took place from March 1 to April 1, 2025.

A population of 42 young psychiatrists was identified. The average age of these young practitioners was 27.95 years, with a sex ratio of 5. The majority of participants (31%) were fourth-year psychiatry residents. Among the participants, only 21% (n=9) identified themselves primarily as “sexologists” or “sex therapists”." Sexology still accounted for less than 31% of the practitioners’ professional activity, with less than 10% of professional activity in 69% of cases. More than half of the psychiatrists (71%, n=30) only asked questions about sexual dysfunction exceptionally or sometimes during a consultation.

As was the case for other populations surveyed previously in our country, psychiatry residents had a clear lack of certain attitudes regarding sexuality. At the end of this study, we suggest the introduction of some sexology courses as part of the teaching programs at the Faculty of Medicine in Sfax. This will promote the good sexual health of our patients and contribute to better mental balance.

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Sexuality is a fundamental human need. Contrary to popular belief, sexual activity is maintained in patients with mental illness, whose sexual interest and desire evolve with treatment without disappearing. Despite the importance of sexual health for patients receiving psychiatric care, communication about sexuality between doctors and patients faces several obstacles and shortcomings. Among these limiting factors are the practices of psychiatric residents with regard to patient sexuality.

The objectives of our study were to evaluate the practices of psychiatric residents with regard to patient sexuality in Tunisia and to determine the factors associated with the nature of these practices in this population.

This was a descriptive and analytical study with cross-sectional data collection conducted on a population composed of a sample of psychiatry residents practicing in Tunisia at all levels: from the first to the fifth year. Our study was based on an online questionnaire and assessed participants’ Practices of sexuality. It took place from March 1 to April 1, 2025.

Forty-two young psychiatrists were identified. The average age of these young practitioners was 27.95 years. The majority of psychiatrists participating in the study were female (83%; n=35). The majority of participants (31%) were fourth-year psychiatry residents. The pharmacological approaches that psychiatrists often used to treat SDs were mainly the prescription of IPDE5 (often or sometimes prescribed by 26% and 12% of practitioners, respectively). Specific sexological approaches were only practiced by a minority of psychiatrists (only 17% for CBT and 33% for couples therapy), with the exception of supportive psychotherapy and marital counseling (43% of psychiatrists) and sexual information provided by 71% of psychiatrists. Regarding the factors influencing doctors’ practices, we found a significant negative relationship between gender and pharmacological approaches (p=0.001). We observed a statistically significant difference between the different stages of residency in terms of pharmacological approaches to patients’ sexuality (p=0.001). Furthermore, a significant relationship was found between pharmacological approaches and residents with degrees in sexology (p=0.01). Finally, a significant relationship was found between pharmacological approaches and patient satisfaction (p=0.023).

There are several gaps in Tunisian doctors’ practices regarding their patients’ sexuality. At the end of this study, we suggest the generalization of sexology education in all medical schools in Tunisia and, above all, the participation of residents in specific sexology consultations. This will promote the good sexual health of our patients and contribute to better mental balance.

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Sexual dysfunction is a frequent adverse effect of antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). It is often underestimated and may compromise treatment adherence. Few studies have examined both its prevalence and its impact on adherence in depressed patients.

To assess the prevalence of sexual dysfunction in patients treated with antidepressants and to analyze its relationship with treatment adherence, with a focus on differences between drug classes.

We conducted a descriptive and analytical cross-sectional study over one month including 100 psychiatric outpatients aged 18–65 years, diagnosed with a major depressive episode, and treated with antidepressants for at least four weeks. Patients with a history of sexual dysfunction, severe somatic comorbidities, or psychoactive substance use affecting sexuality were excluded. Sexual function was assessed using the Arizona Sexual Experience Scale (ASEX), adherence with the Morisky Medication Adherence Scale (MMAS-8), and depression severity with the Montgomery–Åsberg Depression Rating Scale (MADRS).

The sample included 60 women and 40 men, with a mean age of 38.5 ± 12.2 years. Treatments were mainly SSRIs (65%), followed by SNRIs (25%) and other antidepressants (10%).

The overall prevalence of sexual dysfunction was 42%, mainly affecting orgasm (50%), sexual satisfaction (48%), and desire (45%). The mean ASEX score was 19.0 ± 5.2.

Treatment adherence, assessed by the MMAS-8, was insufficient in 35% of patients. Sexual dysfunction was significantly associated with poorer adherence (55% vs 22%, p < 0.01). A negative correlation was found between ASEX and MMAS-8 scores (r = –0.42, p < 0.01), indicating that greater severity of sexual dysfunction was linked to lower adherence.

Sexual dysfunction prevalence varied according to drug class: 50% with SSRIs, 44% with SNRIs, and only 10% with bupropion/mirtazapine (p < 0.01). Adherence followed the same trend, with poorer adherence under SSRIs (40%) and SNRIs (36%) compared with atypical antidepressants (10%).

Sexual dysfunction is common among patients receiving antidepressants and is strongly associated with non-adherence, particularly under SSRIs and SNRIs. Routine screening and appropriate management are essential to improve adherence and optimize depression outcomes.

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The demanding academic environment is a potential source of stress for nursing students, and the inability to cope effectively often exacerbates this burden.

To assess the level of perceived stress among nursing students, identify its risk factors and manifestations, and evaluate its impact on their learning.

A descriptive cross-sectional study was conducted among students at a private nursing institute in Sousse, using a questionnaire administered between February and March 2023. Perceived stress was measured using the Perceived Stress Scale (PSS).

The study population was predominantly female (75.7%) with a sex ratio of 0.32. The mean age was 21.5 years, and second-year students represented 66.7% of the sample. The average perceived stress score was 27.21 ± 5.71 (range: 18–35). Nearly two-thirds of participants (60.7%) experienced persistent stress (score > 26). The main stressors related to theoretical learning were examinations (36.7%) and the need to adapt to new academic demands and heavy workloads (36.3%). Regarding clinical learning, the most frequently reported stressors were fear of failure (65.7%) and deteriorating clinical training conditions (52%). Somatic manifestations included sleep disturbances (72.3%) and headaches (72%). Psychological manifestations included decreased motivation (72%) and mood instability (65%). Stress negatively impacted learning, as 88% of students reported increased delays and absenteeism from classes and internships, while 66% indicated difficulty in understanding courses, case studies, and clinical activities when stressed. Suggested coping strategies included systematic screening (66.7%) and stress management training (64%).

The moderate stress levels reported by nursing students highlight the need for structured stress management programs and appropriate support systems. As future healthcare providers, early interventions during academic training and clinical practice are essential to reduce stress and strengthen coping abilities.

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Psychosocial stress may upregulate low-grade inflammation implicated in atherosclerosis. High-sensitivity C-reactive protein (hs-CRP) is a validated biomarker of cardiovascular inflammatory risk (low <1 mg/L, average 1–3 mg/L, high >3 mg/L). The Perceived Stress Scale (PSS-10) offers a quantification of stress in clinical-epidemiological settings.

To evaluate the association between perceived stress levels and High-sensitivity C-reactive protein value among healthcare professionals

We conducted a cross-sectional analytic study among hospital personnel at CHU Farhat Hached (Sousse, Tunisia). Perceived stress was assessed with the 10-item Perceived stress Score (PSS-10). Fasting blood (≥12 h) was analyzed for hs-CRP in the biochemistry laboratory. Associations between stress and hs-CRP were explored using Spearman correlation and Mann–Whitney tests, following the predefined analysis plan.

Among participants with available hs-CRP (n=9 of 133 with PSS-10), mean age was 43.8±9.9 years; 8/9 were women; mean BMI 26.9±3.8 kg/m². Median hs-CRP was 2.0 mg/L (IQR 1–3); 2/9 (22.2%) were in the high-risk category (>3 mg/L), and 7/9 (77.8%) in the average-risk category (1–3 mg/L). One value exceeded 10 mg/L (20 mg/L), a level for which retesting to exclude acute inflammation is recommended. PSS-10 averaged 20.1±3.8; most participants were in the moderate stress range (8/9), with 1/9 low and none high. Stress and hs-CRP showed a positive but non-significant correlation (Spearman ρ=0.29; p=0.44). Median hs-CRP was 1.0 mg/L in the low-stress group vs 2.0 mg/L in the moderate-stress group (Mann–Whitney p=0.42). In a sensitivity analysis excluding the single value >10 mg/L, the correlation remained non-significant (ρ=0.35; p=0.39).

In this preliminary subset with hs-CRP, perceived stress trended positively—but not significantly—with hs-CRP. Most values fell in the “average-risk” range, with a minority >3 mg/L. These early findings mirror the mixed literature on the stress–CRP link and highlight the need for larger samples and careful handling of potential acute inflammatory outliers when evaluating low-grade inflammation in shift-working healthcare staff.

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Sleep disorders are highly prevalent worldwide, and medical students (MS) are particularly vulnerable because of the considerable academic pressure they face.

This study aimed to investigate the prevalence of insomnia among medical students and to identify their associated factors

A cross-sectional study was conducted among a randomized sample of MS in Sfax, Southern Tunisia, during the Academic year 2024-2025. Data collection was performed using an anonymous self-administered questionnaire including the validated Insomnia Severity Index. A cut-off score of 8 or higher was adopted to determine the prevalence of insomnia among participants

A total of 73 MS were eligible for the study. The median age was 21 years with an interquartile range (IQR)= [20-23,5 years]. There were 41 females (56.2%), giving a male to female ratio of 1.28. History of chronic disease was noted among 14 MS (19.1%) and 41 MS had neck pain (56.2%). As for lifestyle behaviours, 23 MS (31.5%) were smokers and 8 MS (11%) practised sports.

Prevalence of Insomnia among MS was 60.3% (n=44), of whom, 3 MS (6.18%) had Severe insomnia.

Insomnia was statistically associated with having chronic disease (OR=2,1; p=0,04), having neck pain (OR=1.951; p=0.011), depression (OR=1.715; p=<0.001), anxiety (OR=1.696; p=0.025) and stress (OR 1.409; p=0.013). Besides, practicing sports was statistically associated with lower prevalence of insomnia among MS (OR=0.21; P=0.034).

A high prevalence of Insomnia was observed among MS, with multiple psychological and lifestyle factors associated with insomnia. These findings highlighted the need to prioritize mental health interventions to promote well-being and improve sleep quality in this vulnerable population.

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Truck drivers often experience long work hours, sleep deprivation, and occupational stress, which can contribute to emotional distress and impair sleep quality. Excessive daytime sleepiness (EDS) is a common complaint and may be influenced by symptoms of depression, anxiety, and stress.

To examine whether symptoms of stress, anxiety, and depression are significant predictors of excessive daytime sleepiness among Brazilian truck drivers.

A cross-sectional study was conducted with 597 male truck drivers between April and July 2023 in the municipalities of Formosa and Rio Verde, Goiás, Brazil. Participants completed a structured questionnaire on sociodemographic, occupational, behavioral, and psychosocial characteristics. EDS was assessed using the Epworth Sleepiness Scale (cutoff ≥10). Symptoms of depression, anxiety, and stress were measured using the DASS-21 scale, with the following cutoffs for high risk: depression ≥14, anxiety ≥10, and stress ≥19. Logistic regression analyses (bivariate and multivariate) were performed to identify associations.

Excessive daytime sleepiness was reported by 36.2% of participants. The prevalence of high-risk symptoms was 13.6% for depression, 19.8% for anxiety, and 9.0% for stress. In bivariate analyses, EDS was significantly associated with high-risk levels of stress (OR = 4.03; 95% CI: 2.22–7.30), anxiety (OR = 3.32; 95% CI: 2.19–5.04), and depression (OR = 2.52; 95% CI: 1.56–4.05), all p < 0.001. In the multivariate model, stress (OR = 2.63; 95% CI: 1.37–5.02; p = 0.004) and anxiety (OR = 2.59; 95% CI: 1.62–4.15; p < 0.001) remained significant predictors, while depression was not (p = 0.567).

Symptoms of stress and anxiety were independently associated with greater odds of excessive daytime sleepiness among truck drivers, highlighting the role of mental health in sleep regulation. These findings emphasize the importance of integrating psychosocial assessments into occupational health strategies to promote both mental well-being and road safety in this vulnerable workforce.

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Healthcare professionals work in a highly demanding environment characterized by long working hours, significant psychological stress, and frequent shift work. These occupational factors place them at a high risk for developing sleep disorders.

The aim of this study was to assess the prevalence of excessive daytime sleepiness, a key indicator of underlying sleep disorders, among healthcare staff at a university hospital in Tunisia.

A cross-sectional study was conducted from May to August 2023 among 300 permanent healthcare staff at the Farhat Hached University Hospital in Sousse. Data on socio-demographic, professional, and lifestyle characteristics were collected via face-to-face interviews using a pre-established questionnaire. Daytime sleepiness was assessed using the Epworth Sleepiness Scale.

The study population was predominantly female (80%) with a mean age of 43.6±10.2 years. Nurses constituted the largest professional group (40.3%) and most participants (70.3%) worked fixed hours. The average length of professional experience was 15.8±10.9 years. Sleep disorders were reported by 39.7% (n=119) of the participants. The mean sleep duration was 6.6 ± 1.3 hours (range: 3-12 hours). Excessive daytime sleepiness, defined as an Epworth Scale score >10, was present in 22.3% (n=67) of healthcare staff, with a mean Epworth score of 7.5 ± 3.8.

This study reveals a significant prevalence of sleep disorders and excessive daytime sleepiness among healthcare staff. With nearly one in four staff members reporting levels of sleepiness that could impair cognitive function and performance, these findings highlight a critical issue for both staff well-being and patient safety and underscore the need for targeted occupational health interventions such as sleep hygiene education.

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Researchers claim that the quality of sleep in medical students is subnormal, which may be due to a strenuous mental load they have while studying at university. How can such a highly stressful atmosphere influence a student’s self-esteem?

Our objective was to find out the interrelations of the sleep quality and sleep disorders with self-rated personal traits, states and behavior.

When questioning 70 medical students of both gender aged 18-34, we used the Pittsburgh Sleep Quality Index (PSQI) questionnaire. We determined the students’ personal traits, states and behavior with the help of a self-rated questionnaire (Nikolaev, 2023), which evaluated the intensity of personal attributes on a 10-point scale. For mathematical treatment, we used the methods of descriptive statistics and correlational analysis.

The research revealed that two thirds of medical students (65.71%) experienced deterioration of their sleep quality. The mean score of the intensity of self-rated personal traits, states and behavior showed as follows: religious faith (8.79±1.90), happiness (8.34±2.18), confidence (8.07±2.27), successfulness (7.77±2.13), attractiveness (7.70±1.99), health (7.54±1.71), intelligence (6.99±2.15), well-being (6.86±2.61), physical fitness (5.56±2.49). PSQI global score in the surveyed students negatively correlates with their self-confidence (r=-.29; p<.05), happiness (r=-.25; p<.05), and health condition (r=-.24; p<.05). Sleep disturbance negatively correlates with confidence (r=-.30; p<.05) and attractiveness (r=-.28; p<.05). Poor sleep quality negatively correlates with the self-assessment of confidence (r=-.56; p<.05), happiness (r=-.37; p<.05), religious faith (r=-.29; p<.05), and frequency of physical activity (r=-.24; p<.05).

Sleep quality in medical students correlates most of all with such a personal trait as confidence. However, it has weaker connections with the students’ perception of happiness and health. As sleep disorders may bring about deterioration of a personality’s psychological well-being, the revealed self-esteem related correlates might become a target for psychotherapists when working with university students.

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Night shift work, although necessary in the hospital sector, disrupts circadian rhythms, impairs sleep quality, and increases the risk of anxiety and depressive disorders. While this issue is well documented internationally, it remains understudied in Moroccan healthcare professionals. Addressing this gap is crucial, as understanding the mental health consequences of night work is key to improving staff well-being and patient care.

This study aimed to assess the impact of night shift work on sleep quality and mental health among healthcare staff at Mohammed VI University Hospital in Marrakech, by comparing night and day workers.

We conducted a cross-sectional descriptive study among medical and paramedical staff at Mohammed VI University Hospital. All hospital staff were included in the study. Exclusion criteria included psychiatric disorders diagnosed prior to employment and pre-existing sleep disorders (e.g., sleep apnea, narcolepsy, chronic insomnia). An online questionnaire was distributed vi the hospital Whatsapp group; to collect sociodemographic and professional data, alongside the Pittsburgh Sleep Quality Index (PSQI) and the Hospital Anxiety and Depression Scale (HADS). Responses were collected over one month (22 February–22 March 2025). Participants were divided into two groups: night workers (> 4 night shifts/month) and day workers (≤4 night shifts/month).

Out of 279 questionnaires collected, 7 were excluded due to pre-existing sleep or psychiatric disorders. The final sample included 272 participants, of whom 76% (n = 212) were physicians and 24% (n = 60) nurses. Two groups were defined: 50.3% (n = 137) worked > 4 nights/month, and 49.6% (n = 135) worked ≤ 4 nights/month. Night shift workers had significantly poorer sleep quality compared to day workers, with higher mean PSQI scores (p = 0.005). Depression was more pronounced in this group, with higher mean scores (8.7 vs. 6.94) and a significantly higher prevalence of clinical depression (16.7% vs. 5.6%; p = 0.032). Correlation analysis revealed a significant association between poor sleep quality and increased levels of depression (r = 0.401, p < 0.001) and anxiety (r = 0.392, p < 0.001). These findings suggest that sleep disturbances related to night work may contribute to the worsening of anxiety-depressive symptoms among hospital staff.

Night shift work negatively affects sleep quality and increases the risk of anxiety and depressive disorders among healthcare professionals. Improved scheduling, sleep hygiene strategies, and psychological support are needed to preserve staff well-being. These findings highlight the urgency of preventive strategies and institutional policies that prioritize the mental health of healthcare workers.

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Work-related stress in the healthcare sector is a major challenge due to its impact on the quality of care and the well-being of healthcare workers. Among the most exposed units, operating rooms stand out for their highly demanding environment, characterized by urgency, technical complexity, and the vital responsibility of the procedures performed.

The aim of this study was to assess perceived stress among anesthetic technicians (AT) and evaluate its associated factors.

We conducted a cross-sectional study among AT in two University Hospitals in Sfax, Tunisia, between January and October 2024. Sociodemographic and professional data were collected. Physical exertion was evaluated on a scale of 1 to 10. Perceived stress was evaluated using the Perceived-Stress-Scale-10 (PSS-10).

Our population consisted of 77 AT with a mean age of 47.32±7.74 years. Five participants (6.5%) were males. The median Body Mass Index (BMI) of our population was 25.71 IQR [23.87; 28.94]. Medical history was noted in 93.5% of the population. Psychiatric and neurological diseases were found in 15.6% and 9.1% of the population respectively. Physical and Leisure activities were found in 13% and 24.7% of the population respectively. The median job tenure was 7 years IQR [3; 13]. Fourteen participants (18.2%) worked in Pediatric Surgery Unit (PSU). The median of the physical exertion was 7 IQR [5; 8]. The mean of the PSS-10 score was 18.5±6.5. Moderate and high scores were found in 66.2% and 13% of the population, respectively. Multivariate analysis showed that BMI (β=0.213; p=0.049), physical exertion (β=0.429; p<0.001), working in PSU (β=0.271; p=0.019) were significantly associated with a higher PSS-10 score. Job satisfaction was associated with a lower PSS-10 score (β=-0.233; p=0.032).

Our results showed that higher stress was observed in AT working with pediatric patients whereas job satisfaction was associated with lower stress score. These results call for the implementation of adequate support strategies and pave the way for future research on stress prevention.

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Sleep disorders are increasingly prevalent and often underestimated in the general population. Their consequences include cognitive impairment, mood disturbances, and an increased tendency to self-medicate, particularly in contexts where access to specialized care is limited.

This study aims to assess sleep quality and characterize sleep disturbances among a Tunisian population using the Pittsburgh Sleep Quality Index (PSQI).

A cross-sectional descriptive study was conducted between august and november 2024 involving a sample of 287 participants from the general Tunisian population. Data were collected via an online questionnaire, including sociodemographic variables and the validated Arabic version of the PSQI. A PSQI global score ≥6 was considered indicative of poor sleep quality.

The study included a total of 287 participants from the general Tunisian population. The majority of participants (52.96%) were aged between 26 and 35 years, with a gender distribution of 60.98% female. In terms of marital status, 41.81% of participants were single and 39.02% were married. Most participants (88.15%) had a university-level education. Regarding employment status, 65.16% were employed.

The majority of participants reported experiencing sleep disturbances, with the global PSQI score averaging 11.55 ± 3.5. A total of 33.79% of participants scored ≥6 on the PSQI, indicating poor sleep quality.

As for sleep patterns, 49.1% of participants went to bed between 9:00 PM and midnight, while 47.4% went to bed between midnight and 4:00 AM. Regarding wake-up times, 69.7% of participants woke up between 4:00 AM and 8:00 AM, while 24% woke up between 8:00 AM and noon.

Regarding sleep duration, 34.14% of participants reported sleeping between 6 and 7 hours per night, and 30.66% reported sleeping more than 7 hours. However, 13.93% of participants reported sleeping less than 5 hours on average.

Almost half of the participants (55.5%) reported chronic insomnia.

The study highlights the significant prevalence of poor sleep quality and disturbances within the Tunisian population. Addressing these issues could improve public health outcomes, with a focus on enhancing awareness and intervention strategies for better sleep hygiene and management of sleep disorders.

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Sleep disorders, particularly insomnia, are a widespread concern, with many individuals turning to self-medication for relief. While self-medication may provide immediate comfort, it carries significant risks due to the absence of medical supervision. Understanding the motivations behind this behavior, the perceived risks, and the sources of information individuals rely on is essential to fostering safer health practices and improving sleep disorder management.

This study aims to explore the motivations behind self-medication for sleep disorders in Tunisia, identify the perceived risks, and investigate the information sources influencing this practice.

An online cross-sectional study was conducted between August and November 2024 using a self-administered questionnaire. The survey was distributed through social media platforms, targeting adults in Tunisia. The questionnaire collected data on sociodemographic characteristics, self-reported insomnia symptoms, self-medication practices, motivations, side effects, sources of information, and knowledge of associated risks.

Among 287 participants, 60.98% were women and 39.02% men, with most aged 26–35 years (52.96%). Most lived in urban areas (93.38%), had a university degree (88.15%), and were employed (65.16%).

Self-medication for insomnia was reported by 23.69%, mainly due to ease of access (55.88%), preference for natural remedies (52.94%), and prior positive experiences (39.7%). Adverse effects occurred in 28.45%, mostly mood changes (88%), daytime sleepiness (73%), and headaches (48%).

Regarding risks, 40.77% were unaware of dangers, while informed participants cited drug dependence (43.52%), side effects (40.58%), and long-term health issues (27.05%). Sources of information included the internet (80.88%), physicians (69.11%), family/friends (42.64%), and pharmacists (35.29%). Notably, 61% never received professional advice, while 51.6% used non-pharmacological strategies like relaxation or meditation.

Self-medication for sleep disorders is common in Tunisia, driven by accessibility and natural remedy preferences. While some are aware of the risks, many lack professional advice. These findings emphasize the need for improved education and healthcare guidance on safe sleep management practices.

None Declared

Self-medication for sleep disturbances is a growing public health concern, particularly in the absence of medical supervision. Identifying the factors associated with this behavior is essential to guide targeted prevention strategies and promote safer sleep health management.

To explore sociodemographic, clinical, behavioral, and sleep-related factors associated with self-medication for sleep disorders in a sample of the general Tunisian population.

We conducted a descriptive and analytical cross-sectional study using an anonymous online questionnaire disseminated via social media platforms. The study targeted Tunisian adults aged 18 to 65. Data collected included sociodemographic characteristics (age, gender, marital status, number of children, educational level, occupation, place of residence, and work schedules), clinical history (including psychiatric and somatic conditions), sleep-related variables (using the Pittsburgh Sleep Quality Index - PSQI), lifestyle habits, perceived stress, and self-medication practices. Data were analyzed using SPSS, and descriptive and inferential statistics were applied.

We included 287 participants, mostly women (61%) and young adults (53% aged 26–35). The majority lived in urban areas (93%) and 21% reported psychiatric history. Stress levels were moderate to high in most participants.

The average PSQI score was 11.55 ± 3.5, with 33.79% of participants indicating sleep disturbances.

Bivariate analysis showed that female gender, psychiatric history, psychiatric treatment, higher stress, higher PSQI scores, longer sleep problems, and medical consultation were significantly associated with self-medication. Adverse effects of non-prescribed hypnotics and professional advice on risks were also linked to higher self-medication, while physical activity was protective.

Multivariate analysis revealed two independent predictors of self-medication: experiencing adverse effects from hypnotics (B=1.818; p<0.001) and receiving professional advice about risks (B=0.746; p=0.039).

Self-medication for sleep disorders in Tunisia is driven by a complex interplay of psychological, clinical, and informational factors. The association with psychiatric history, perceived stress, and even prior medical advice highlights a gap in patient care and communication. Addressing these factors through clearer guidance and better mental health support is essential to reduce reliance on unsupervised treatments and promote safer sleep practices.

None Declared

Insomnia frequently co-occurs with depressive and anxiety disorders, worsening symptom severity and functioning. Therapist-delivered CBT-I via videoconference (telehealth CBT-I) and digital CBT-I (dCBT-I; web/app) scaled widely, yet effect sizes, completion and safety in comorbid samples remain variably reported.

(1) Quantify effectiveness on insomnia; (2) estimate effects on depressive/anxiety symptoms; (3) assess adherence and safety in adults with mood/anxiety comorbidity.

Targeted searches (2020–2025) in MEDLINE/PubMed, Embase, PsycINFO, Web of Science; adults ≥18 y; clinical/community. Designs: meta-analyses, RCTs, pragmatic/observational cohorts, open trials (quantified). Outcomes: ISI response ≥7, remission (ISI<8), PHQ-9, GAD-7, completion/attrition, AEs. Comparators: TAU, wait-list, sleep-education, in-person CBT-I. De-duplicated 41; screened 41; full-text 21; included 12; excluded 9 (unclear comorbidity 4; non-quantifiable 3; paediatric/protocol 2). Population characteristics inconsistent; one large cohort mostly male veterans.

Telehealth CBT-I cohort: 66% response/43% remission; 56% completed ≥5/6; ΔISI −9.9; similar all-video vs mixed. Two RCTs: non-inferior to in-person (−7.5 vs −7.8, 3 mo; margin 3 ISI).

dCBT-I: 2023 meta-analysis—large insomnia effects (moderate-large) and moderate reductions in depression (~0.4 SD) and anxiety (~0.3 SD) to 6 mo vs TAU/wait-list/education. Smartphone RCT: sleep efficiency +10.7 pp (3 mo) and +9.4 pp (6 mo) vs education (transdiagnostic; comorbidity not consistently reported). Head-to-head (secondary care): fully automated dCBT-I inferior to individual CBT-I at 9 wk (response 43% vs 70%; remission 18% vs 52%) and ~33 wk (remission 24% vs 56%).

MDD+insomnia: CBT-I increased antidepressant response to 32% vs 17% (OR≈2.3; NNT≈8) and improved insomnia remission vs TAU/wait-list. GAD+insomnia (open): response 61%; remission 26–48%; AEs ~33%, typically mild/transient during sleep-restriction. Serious AEs unreported; AE reporting sparse/heterogeneous.

Telehealth CBT-I non-inferior to in-person; achieves 66% response/43% remission in real-world care. dCBT-I improves insomnia and reduces depression (~0.4 SD) and anxiety (~0.3 SD); fully automated may underperform individual CBT-I, supporting guided/stepped-care. Implication: first-line in stepped-care; intensify for non-responders. Limitation: platform/comparator/subgroup heterogeneity and under-representation of women in veteran samples limit %-to-% comparisons/generalizability.

None Declared

Major depressive disorder (MDD) is characterized by profound sadness, low energy, and fatigue. Sleep disturbances affect 75–90% of patients and increase suicide risk (WHO 2017). Sleep is essential for brain, immune, metabolic, and cardiovascular health (Vorster et al. Clin Transl Neurosci 2024; 8:8). Despite guidelines, sleep problems remain common in psychiatric populations (Nutt et al. Dialogues Clin Neurosci 2008; 10:329–36). This study explores treatment and counseling practices for depression-related sleep disturbances to inform outpatient care.

To examine how patients with MDD experience current treatments for sleep disturbances and to identify ways to strengthen clinical practice with pharmacological and non-pharmacological approaches.

Using a hermeneutic, inductive design, semi-structured interviews were conducted with 12 patients diagnosed with MDD and reporting sleep disturbances. Participants were recruited through psychiatric outpatient clinics in Denmark via providers, conferences, emails, and flyers. Interviews (45–50 minutes) were carried out between February and April 2024 in clinics or patients’ homes. The study followed SRQR guidelines (EQUATOR Network 2023), adhered to the Helsinki Declaration (World Medical Association 2008), and was approved by the Danish ethics committee (protocol no. 20232000-151).

Analysis is ongoing, applying Braun and Clarke’s thematic content analysis (Braun & Clarke. Qual Res Psychol 2006; 3:75–101) with NVivo software (Zamawe. Malawi Med J 2015; 27:13–5). Preliminary findings indicate a predominant reliance on pharmacological treatments, often linked to adverse effects, while awareness of non-pharmacological options appears limited. Early interviews highlight a need for enhanced training among healthcare professionals to broaden treatment strategies.

This study will provide insights into patients’ perspectives on managing sleep disturbances in MDD. Early results suggest over-reliance on pharmacological therapy and limited use of alternatives. Final conclusions and clinical implications will be presented at the conference.

None Declared

The impact of sleep disturbances on cognitive function is well-established in the general population. However, during the psychiatric high-risk periods of pregnancy and postpartum, characterized by substantial sleep disturbances, the impact of sleep on cognition is understudied. Some studies have found that the connection between sleep disturbance and cognitive function may be strongest among individuals experiencing depressive symptoms.

We administered a comprehensive cognitive battery in pregnant and postpartum individuals and examined its relationship with sleep disturbance in the third trimester of pregnancy and at three months postpartum.

Participants completed the Cambridge Neuropsychological Test Automated Battery (CANTAB) in the 3rd trimester (N=274) and at 3 months postpartum (N=203). Tasks assessed executive functioning (One Touch Stockings of Cambridge, Cambridge Gambling Task), memory (Paired Associates Learning, Spatial Working Memory, Delayed Matching to Sample, Pattern Recognition Memory), and attention (Rapid Visual Information Processing). A subset also completed the PHQ-9, a screening measure which assesses sleep difficulty, and the Edinburgh Postnatal Depression Scale (EPDS). Sleep disturbance was defined as a score >0 on PHQ-9 item 3. A cross-sectional analysis was performed at each time point correlating the PHQ-9 item with the 7 individual cognitive task z-scores and composite domain scores using Spearman’s rank correlation. Additionally, the correlation between change in sleep items and z-scores within participants at each time point was examined using Spearman’s rank correlation. Finally, we examined the prevalence of mild cognitive impairment, defined as a z-score ≤−1, across both timepoints and its association PHQ-9 item 3. Analyses were performed at three levels: (1) unadjusted, (2) stratified by EPDS total (<10 vs ≥10), and (3) adjusted for EPDS score using rank-based regression.

During pregnancy, 51.7% had a sleep disturbance on PHQ-9 item 3 (N=149). At 3 months postpartum 30.2% had a sleep disturbance on PHQ-9 item 3 (N=129). Greater increases in sleep disturbance were associated with greater decreases in quality of decision making on the Cambridge Gambling Task between pregnancy and postpartum (Estimate = -0.45, P = 0.01; N = 62), after adjusting for EDPS depression scores. In unadjusted and EPDS stratified analysis, there were no significant cross-sectional or longitudinal associations between PHQ-9 sleep scores and cognition.

We found an association between increased sleep disturbance between pre-and post-partum and quality of decision making when controlling for depression. Further research is needed to explore potential mediating factors and to use more fine-grained measures of sleep quality and duration.

Y. Schmitt: None Declared, L. Ospina: None Declared, M. MccLure: None Declared, M. M. Perez-Rodriguez Grant / Research support from: Principal Investigator of Grant to Mount Sinai from Neurocrine Biosciences (unrelated to this presentation), Consultant of: Consultant with Neurocrine Biosciences and Mitsubishi Tanabe Pharma Corporation (unrelated to this presentation).