Bipolar disorder is presumed to involve difficulties in emotion regulation. However, little is known about the specific emotion regulation profile associated with this disorder.

To study emotion regulation in bipolar patients in remission phase and to determine the factors correlated with it.

A cross-sectional, descriptive and analytical study of 30 patients followed for bipolar disorder in remission, at the psychiatric outpatient clinic at the Hédi Chaker University Hospital in Sfax. We used a socio-demographic and clinical data sheet and the Cognitive Emotion Regulation Questionnaire (CERQ) which assesses cognitive strategies (maladaptive and adaptive) for regulating emotion.

The mean age of the patients was 43.77 years, the sex ratio was 0.5. Bipolar I disorder was diagnosed in 93% of patients. A good adherence to treatment was found in 86.7% of cases and a good social integration in 40%. The mean total score of the adaptive CERQ was 66.73 and the most used adaptive strategy was acceptation (mean score =13.87), while the mean total score of the maladaptive CERQ was 36.7 and the most used maladaptive strategy was self blame (mean score =9.47). Adaptive cognitive emotion regulation was predominant in 93.3% of patients. It was significantly correlated with good adherence to treatment (p = 0.047) and good social integration (p = 0.026).

Our patients with euthymic bipolar disorder showed a satisfying level of adaptive emotion regulation strategies. A cognitive remediation seems important to embetter this capacity and improve the income of the disease.

No significant relationships.

Since COVID19 pandemic emergence, containment measure have been taken by the Tunisian government imposing a new lifestyle resulting in psychological repercussions and a change in behavior.

Highlighting changes of behavior and lifestyle of the general public secondary to the COVID19 pandemic and to confinement and to assess their levels of psychological.

This is a qualitative, descriptive and analytical cross-sectional study realized between April and May 2020 with the general public using an anonymous online questionnaire covering: socio-demographic data; behavior during confinement; epidemic psychological impact; Mental health status was measured using Depression, Anxiety and Stress Scale(DASS-21). Anger level was assessed by STAXI-10 items.

132 responses were received: 68.2% were women; the average age 32.01(±11.10); half were single; 77.3% were at higher education level; 41.7% were healthcare professionnels. Consumption increased by 26.5% in coffee, 8.3% tobacco and 1.5% alcohol. 33.3% of participants increased their religious practice. 56.1% experienced sleep disorder mostly women(p<0.05). 91.7% followed COVID19 evolution through media essentially Facebook. Partners relationship was deteriorated in1.7% and improved in 25%. Child abuse increased by 13.7%. During confinement: 15.9%depression (0.8%severe depression), 12.9%anxiety (0.8%severe anxiety), 5.3% stress and 27.3%feelings of anger. Depression, anxiety and anger were related to younger age(p<0.05). Stress wasn’t age related. Depression was observed in participants without children (p<0.05). No association founded between psychological impact and gender, profession and civil status.

The COVID19 pandemic and the containment had consequences on individuals behavior and mental health. A psychological listening unit was launched during the period of confinement to overcome psychological impact.

Widespread outbreaks of infectious disease, such as COVID-19, are associated with psychological distress and symptoms of mental illness especially for patients with suggestive symptoms.

Predict the prevalence of perceived stress and study associated factors among patients with suspected COVID-19 infection.

A cross sectional study was conducted between April and May 2020. Patients consulting the sorting box at the Hedi Chaker Hospital of Sfax and declared suspect to be infected by COVID-19 were invited to participate in our study after given their cosent. Perceived Stress Scale-10 was used to evaluate prevalence of perceived stress.

In total, 149 participants participated. The mean age was 38.8±15.39 years. Medical or surgical history and psychiatric history were identified respectively in 30,2% and 12.1% of participants. Among all respondents, 74.5% took a nasopharyngeal swab to look for COVID-19 and only 6.4% had a positive test. Close contact with someone with a positive COVID-19 infection was found in 8.05%. Several participants (79,2%) expressed fear of transmitting the disease to their family members. The mean of the PSS-10 score was 11.97±9.83. Moderate to severe perceived stress was found in 44.3% of patients. Significantly higher scores were observed among participants with a positive pharyngeal swab for COVID-19 as well as those who perceived worry of transmetting the disease. No significant differences in perceived stress’ scores according to socio-demographic data.

Perceived stress was high among patients with suspected COVID-19 infection. Perceiving worry of transmetting the disease and having a positive pharyngeal swab for COVID-19 were the principal risk factors.

No significant relationships.

The postpartum depressions (PPD), rank first postpartum complications and therefore pose a public health problem by their frequencies and their adverse consequences.

To detect the depression among a Tunisian parturient, to evaluate their perceived stress and to study the link between these entities

A cross-sectional, analytical study of 40 first week postpartum women hospitalized in the gynecology department in Hedi Cheker hospital in Sfax-Tunisia, during the month of September 2019. We used the Arab version of Edinburgh Postnatal Depression Scale (EPDS) and the Cohen perceived stress scale (PSS).

The average age of the participants was 31.07 years old. The Parturient have a rural origin in 62.5% of cases, they have a secondary school level in 52.5% of cases. There were exaggerated sympathetic signs in 52.5% of the cases. An organic pathologies were present during pregnancy in 47.5%. The postpartum period was simple in 77.5% of cases. For the post-natal period, 90% of parturient were going to receive help of a family member. EPDS: the average score was5.35 and the risk of developing a PPD was 20%. PSS we found that life represents a perpetual threat in 27% of cases. The factors correlated with the PPD were: a high level of perceived stress (p < 0.00) and organic pathology during pregnancy (p=0.02).

Our study shows that the risk of postpartum depression is high among Tunisian parturient and it is associated with high level of stress, because of this a precocious screening is necessary.

No significant relationships.

Posttraumatic stress disorder (PTSD) is common in survivors of acute life-threatening illness, but little is known about the burden of PTSD in survivors of stroke attack.

This study estimated the prevalence of PTSD in post-stroke in the elderly and to look for the factors which are correlated with it.

Participants were outpatients of Psychiatry B department in Hedi chaker University Hospital Center in Tunisia, over the age of 65, hospitalized in psychiatry for a major depressive episode, recruted between 2000 and 2015. The data was collected using a pre-established sheet containing socio-demographic information, the clinical and evolutionary characteristics of the depressive episode and the therapeutic data concerning the depressive episode.

30 patients were included in this study with an average age (69 Y) and sex ratio (0.66). More than half (53.3%, 16 patients) had a history of chronic somatic disease. The average length of hospitalization was 26 days. The most frequent reason for hospitalization is sadness of mood (43.3%) with cognitive impairment as the predominant clinical symptomatology (40%). 93.3% of the population received as treatment an antidepressant mainly Fluoxetine (50%).

clinicians should be mindful that PTSD can be a devastating mental health condition and should consider screening for PTSD in stroke survivors.

Wernicke’s encephalopathy is a potentially fatal neurological emergency caused by thiamine deficiency. Although it is often associated with chronic alcoholism, it can also occur in all situations that lead to a thiamine deficiency such as undernutrition and exclusive artificial feeding.

In this work, we propose to study the clinical and treatment concerns of Wernicke’s encephalopathy complicating catatonic schizophrenia.

We retrospectively report the case of a patient who developed a Wernicke’s encephalopathy in the aftermath of catatonic schizophrenia.

Mr H.L, a 47-year-old-male has been followed in psychiatric hospital since the age of 27 for catatonic schizophrenia. He has been hospitalized in July 2020 because of oral intake refusal, social isolation and lack of self-care with a poor compliance to treatment. Examination of the patient revealed catalepsy, mutism and negativism. He was treated with antipsychotics drugs, benzodiazepines and parenteral nutrition. About six weeks after his hospitalization, the patient developed horizontal nystagmus and ataxic gait. Magnetic resonance imaging was consistent with Wernicke encephalopathy. Vitamin B1 dosage was 32nmol/l. Parenteral thiamine replacement therapy was initiated with clinical improvement

Catatonic schizophrenia can be associated with severe malnutrition and thus with thiamine deficiency and Wernicke’s encephalopathy. An early intervention by supplying prophylactic thiamine given parenterally in high-risk patients is crucial to avoid Korsakoff syndrome, as well as cardiovascular and neuropsychiatric complications associated with thiamine deficiency.

In March 2020, the World Health Organization characterized the COVID-19 outbreak as a pandemic. This new health situation has created an anxiety-provoking climate, in particular among health professionals

To study the prevalence and predictors of anxiety and depression among health workers

Our study was descriptive and analytical cross-sectional, carried out with healthcare on the period between May until June 2020. An anonymous online survey was sent to caregivers. The HADS questionnaire was used to screen for anxiety and depression

125 responses was collected The average age of the sample was 32 years. The participants were predominantly female (72.8%), married (48%), and had at least one child (39.2%). 21.6% of the participants worked in the resuscitation anesthesia service and urgent medical aid, 14.4% in the medical services at high risk of contamination, 1.6% in the COVID-19 unit Many changes in habits were reported by the participants: 28.7% had increased their consumption of coffee/tea, especially with anxious people (p = 0.001). This increase was also noted for tobacco (30.8%) and alcohol consumption (12.5%). According to the HADS scale, anxiety was retained in 44% and depression in 47.2%. Anxiety was significantly related to sex with (p = 0.039) and affects more women than men The consumers of coffee/tea developed more anxiety (p = 0.034) and depression (p = 0.026).

This tragic health crisis had a major impact on the mental health of our heroes This is why we should better understand their vulnerability to psychological suffering to provide them with the necessary support

Munchausen syndrome by proxy, is a very rare form of abuse, lying on the border between pediatric, psychiatric and legal fields.

To describe a case of Munchausen syndrome by proxy in a mother after the discovery of severe hypoglycemia in her 14-month-old child, hospitalized in the CHU Hédi Chaker Sfax pediatric ward.

This is a presentation of a clinical case and review of the literature via pubmed using the following keywords : “children, abuse, maltreatment, Munchhausen syndrome”.

This is a 23-year-old woman, mother of two daughters, with a psychiatric history, married to a 43-year-old men known to have diabetes on insulin for several years. The patient was admitted to our ward under constraint for aggressiveness towards her one-and-a-half-year-old daughter. Indeed, one month before her hospitalization, her youngest daughter was hospitalized (accompanied by her mother) in the pediatric department at the Hédi Chaker Sfax University Hospital for severe hypoglycemia (0.3g / l). During hospitalization, the girl presented a more severe hypoglycaemia relapses (0.1g / l) and neurological complications. As the mother was indifferent to her daughter’s troubles and was neglectful of her while caring for the other hospitalized children, a mother-child separation was decided and then the blood sugar levels was stabilized. Besides, several other incidents have been happening repeatedly for the two children. In view of the total history, Münchhausen syndrome by proxy has been mentioned.

Munchausen syndrome by proxy is a complex form of child abuse by the mother, representing a major diagnostic and therapeutic challenge for both somaticians and psychiatrists.

Suicide attempts are common in individuals with schizophrenia. These actions are marked by a greater lethality, due to the use of more violent means in particular the intentional ingestion of rodenticides.

To describe the gravity of the heamatological disorders revealing suicide attempts by a rodenticides in patient with schizophrénia.

We repport the case of a patient who present a haematological disorders after an rodenticide intoxication.

A 41-year-old man with schizophrénia since 2011 was brought to the department of psychiatry in july 2020 for behavioral disorders. On arrival, the patient was oriented but reticent and refuse to tell his full story. On examination, his vital signs were normals, and he did not show any externalized bleeding. Bilogical tests revealed the prothrombin time (PT) was <10% with an isolated and unexplained fall in vitamin K-factors. The etiological investigation was negative. Later,the patient admitted attempted suicide by taken 4 rodenticide packages orally three days prior admission to hospital. The initial treatment with intravenous vitamin K almost daily is effective. An improvement in PT (35%) and vitamin K-dependent factors was observed after one week of treatment. A Normalization of hemostasis disorders was obtained after two weeks of treatment.

It is imperative to suspect rodenticide intoxication in patient with scizophrenia with an isolated and an explained deficiency of vitamin K dependent factors. The particularity of this intoxication lies in the dangerous and prolonged side effects making the curative treatment difficult and long.

No significant relationships.

The influence of personality on how people deal with stressful situations has long been discussed. In bipolar disorder, these two entities seem to have a role in the outcome of the disease.

To study the relationships between coping strategies in stressful situations and personality dimensions in euthymic bipolar patients.

This is a cross-sectional, descriptive and analytical study of 30 patients followed for bipolar disorder in remission, at the psychiatric outpatient clinic at the Hédi Chaker Uuniversity Hospital in Sfax. We used a socio-demographic and clinical data sheet and the Ten Items Personality Inventory (TIPI) to evaluate personality dimensions and the Ways Of Coping Checklist (WWC) for the assessment of coping.

The mean age of the patients was 43.77 years, the sex ratio was 0.5. Bipolar I disorder was diagnosed in 93% of patients. WCC : -Coping focused on the problem : 70% of the patients. -Emotion-centered coping : 20% of patients -Coping focused on seeking social support : 10% of patients. TIPI : Conciousness was the most represented trait of personality (36.7%), agreableness (30%) and extraversion (20%). Extraversion was associated with coping focused on the problem: (p=0.015). Agreableness was associated with coping focused on seeking social support:(p=0.033).

Our study showed that conciousness is the most common trait of personality in bipolar disorder patients. The coping focused on the problem is the most frequent strategy which correlated with extraversion, so, personality dimensions appear as a target for cognitive interventions.

No significant relationships.

The rapid spread of coronavirus has forced the healthcare systems in Tunisia to reorganize its structures, thus mobilizing all caregivers. Their professional and emotional burden was put to the test.

To evaluate the level of anxiety and to study coping strategies among caregivers during this pandemic.

A cross-sectional descriptive and analytical study among150 caregivers in two hospitals in Sfax in Tunisia; during April 2020. We used anonymous questionnaire, the Spielberger State Anxiety Scale(STAI) to assess tension felt at anxiety-producing situations; and the Coping Inventory Scale for Stressful Situations (CISS): to assess coping strategies.

The average age was 30.33± 6,93 years and the sex-ratio M/W = 0,29. Caregivers followed the news of this pandemic with these means of communication: 96% Facebook, 80%TV. The increase of the time spent in front of media:84% Sleep disorders were present in 64.7%: insomnia (36%), chopped sleep(34%). Caregivers used sleeping pills in 12% of case. STAI: The mean ascore =48.85 and a high anxiety level was noted in72% of case. CISS: Task-oriented coping strategies : a mean score= 47.90 and Emotion-centered coping : a mean score = 40,49 High anxiety was correlated with: age>40 years old (p=0.042). The increase of the time spent in front of media, chopped sleep and use of sleeping pills are correlated respectively (p= 0,043, p=0,003, p=0,003) with an emotionally focused coping strategy.

Health professionals had a painful psychological experience with significant anxiety. Strengthening prevention strategies, management of health crises should be a priority of our health-system.

Quarantine for suspected patients of being infected by the COVID-19 can lead to negative consequences for mental health and the appearance of depressive symptoms.

To assess the prevalence of depression in quarantined patients, and to analyze the associated factors.

This was a descriptive and analytical survey, carried out from April 4 to May 30, 2020, with 149 patients consulting the COVID-19 sorting box at the Hedi Chaker CHU in Sfax. Suspected COVID-19 patients were contacted by phone during their quarantine and invited to participate in our study. The Patient Health Questionnaire (PHQ-9) scale was used to assess the severity of depression. Cutoffs of 5, 10, 15, and 20 represent minimal, mild, moderate, moderately severe, and severe levels of depression based on PHQ-9 scores. A cutoff score of 10 determines major depression.

The results showed a prevalence of major depression of 10.7%. Of all patients, 89.3% had minimal to mild depression; 10% had moderate to moderately severe depression and 0.7% had severe depression. The PHQ-9 score was statistically correlated with travel to a suspect area during the 14 days preceding the consultation (p = 0.008), contact with a subject confirmed COVID-19 (p = 0.01), previous follow-up in psychiatry (p = 0.047), the change of residence during quarantine (p = 0.045), the fear of transmitting the disease to relatives (p = 0.00) and the positive result of the nasopharyngeal swab (p = 0.00).

Psychological distress was felt in our patients. We recommend that necessary measures should be taken to combat depression.

Psychotropic medications are widely used in Tunisia. Studies about frequency of substance use are rare

The purpose of this work is to determine frequency of use of psychotropic medication among pharmacy students in Monastir University during their university years and during the last year and to assess the factors associated to this consumption

A retrospective study was used to collect the information about 145 participants using a questionnaire asking about the consumption of psychotropic medications and the factors associated to substance use

145 subjects aged 22.71 years +/- 2.04 among them 25% was men and 75 % women. Psychotropic medication use was 20 % during university years and 17.24 % during the last year. 45 % of the users had their medications without a prescription from a doctor. 17 % of the users of psychotropic medication weren’t informed about the effects of the drugs. A higher consumption of psychotropic drugs was observed among older individuals (p=0.009; F=6.928), redoubling individuals (p=0.003), with conflictive relationships with family (p=0.001), using others psychotropic substances, feeling often nervous (p=0.003; F=9.318) and with personal history of mental illness (p=0.002).

Our finding underlines the need of larger more comprehensive surveys to determine the efficiency of the prevention strategies and to minimize the consumption of psychotropic drugs or to control it.

dependence Risk factors drugs students

In Tunisia, the use of cannabis has become an important phenomenon in the society that not well attested by epidemiological studies.

The purpose of this work is to study the socio-demographic criteria of student of the faculty of Pharmacy of Monastir and risk factors encouraging them to consume cannabis and to estimate the extent of the phenomenon of dependence occurring among students.

A questionnaire composed of 45 questions was sent to students of the Faculty of Pharmacy of Monastir via the internet. The data was collected and analyzed using the software’ Google forms’ and ‘statistical package for social Science’ (SPSS)

The prevalence of cannabis use among students of the faculty of Pharmacy was worrying, increasing to 21.4 %, for moments of pleasure and relaxation of the stressful life (p=0 et p=0.008). The frequency of cannabis use had a significant impact on the desire to stop cannabis use (p=0.012). Of the 55 consumers, only 5 tried to stop or reduce cannabis use. About 88% of participants indicated that cannabis was responsible for psychological dependence. Polydrug use (tobacco, alcohol, other drugs) had a significant influence on this use (p=0).

The scourge of cannabis use has invaded not only universities, but also high schools and colleges. At the end of this work, we propose debates to find the necessary means to protect cannabis users cannabis and treat dependents.

Elevated prevalence of somatic disorders (SD) in patients with mental diseases is well recognized and studied since latest years. However, their detection remains too late, which darken the prognosis of both diseases, and complicate the therapeutic management.

We aimed to determine the prevalence of SD in psychiatric inpatients, and to assess relationships between the two diseases.

We analyzed retrospectively the medical records of 94 male patients hospitalized for the first time in psychiatry “B” department, Hedi Chaker hospital (Sfax, Tunisia), in the period from January 1st until December 31st, 2019.

The mean age of patients was 36.88 years. Among them, 22.3% used cannabis and 37.2% consumed alcohol. Schizophrenia (41,5%) and bipolar disorders (20.2%) were the most common psychiatric diagnoses. During their hospitalization, at list one SD was noted in 53.2%: cardiovascular diseases 21.3% (electrocardiographic anomalies 19,1%); infections 9.6% and hepatic pathologies 8.5 %. The SD was comorbid with psychiatric disease in 90%, and represented a side effect of psychotropics in 10% of patients with SD. Older Patients were more likely to present SD during hospitalization, without a significant association. Patients with schizophrenia were significantly more likely to present infections (p=0.031). Repolarization disorders are more common in patients with cannabis use (p = 0.006).

Our study pointed the high prevalence of SD in patients with mental illnesses, especially in those with schizophrenia and cannabis use. Thus, the somatic assessment should be a systematic practice to identify patients at risk for somatic complications and ensure timely their transfer to a specialized setting.

Depression in the elderly represents a major public health problem, due to its high prevalence and its deleterious consequences in terms of morbidity and mortality, in particular by suicide.

1-Draw up the socio-demographic and clinical profile of elderly patients hospitalized in psychiatry for a major depressive episode 2-Determine the semiological and therapeutic characteristics of depression in the elderly.

Participants were outpatients of Psychiatry B department in Hedi chaker University Hospital Center in Tunisia, over the age of 65, hospitalized in psychiatry for a major depressive episode, recruted between 2000 and 2015. The data was collected using a pre-established sheet containing socio-demographic information, the clinical and evolutionary characteristics of the depressive episode and the therapeutic data concerning the depressive episode.

30 patients were included in this study with an average age (69 Y) and sex ratio (0.66). More than half (53.3%, 16 patients) had a history of chronic somatic disease. The average length of hospitalization was 26 days. The most frequent reason for hospitalization is sadness of mood (43.3%) with cognitive impairment as the predominant clinical symptomatology (40%). 93.3% of the population received as treatment an antidepressant mainly Fluoxetine (50%).

Depression and its different modes of expression in the elderly is a serious condition with direct effects on quality of life. Early detection is desirable in order to set up appropriate management, and thus prevent the occurrence of complications such as suicide.

Psychiatric symptoms associated with Primary hyperparathyroidism (PHPT) involved several presentations; the most characteristic is depression. However, PHPT remains often overlooked by physicians when making differential diagnosis for patients with psychiatric disorders, particularly in the elderly.

We proposed to describe the clinical and therapeutic characteristics of major depression secondary to PHPT.

We report a case of PHPT revealed by depression. Then, we conducted a literature review using “PubMed” database and keywords “primary Hyperparathyroidism”, “depression”.

A 73-year-old man presented with a 3-month history of depressed mood, loss of interest, clinophilia, poor concentration, and weight loss. These symptoms were associated with epigastralgia and constipation not responding to symptomatic treatment. The etiological assessment was normal. The diagnosis of major depression was established, and the patient was treated with Sertraline (25 mg/day). After one month of treatment, somatic and psychiatric symptoms worsened. Physical examination revealed a deteriorated general condition, dehydration, and cardiac arrhythmia. Blood analysis revealed renal failure, hypercalcemia (4.2mmol/L), hypophosphatemia (0.4mmol/L), and increased parathyroid hormone level (180 pg/ml). The patient was hospitalized in intensive care unit. Cervical echography showed 2 hyperparathyroid adenomas, and diagnosis of PHPT was established. Under symptomatic treatment, the patient’s somatic and psychiatric condition improved. An hyperparathyroidectomy is undergone soon.

This case highlighted the importance of considering a primary psychiatric disorder as a diagnosis of exclusion, especially in the elderly. PHPT is one of differential diagnoses for psychiatric symptoms, like depression, whose management is conditioned by that of the somatic disease.

The data suggest that anxious drivers may engage in problem behaviors that expose them and others to an increased risk of negative traffic events.

To study the problematic behavior taxi drivers related to anxiety in three areas exaggerated safety/caution, performance deficits, and hostile/aggressive behaviors and to determine the factors who are associated with them.

This is a cross-sectional descriptive and analytical study of 58 taxi drivers in the city of Sfax, Tunisia. We used an anonymous questionnaire that included a socio-demographic fact sheet, and a driver behavior rating scale: Driver Behavior Survey (DBS) with 21 items.

The mean age of the drivers was 40.8 ± 10.2 years. The sex ratio was 0.98. 75.9% were married. 6.9% lived alone. 53.4% were smokers and 25.9% drank alcohol. Coffee and tea consumption were 59% and 33% respectively. 67% had a pathological personal history, including osteoarticular pathologies. 17.2% had a history of serious accidents. The behavior related to anxiety among taxi drivers was 74.66 ± 13.35. The hostile behavior was 18.88 ± 8, the exaggerated safety behavior was 38.31 ± 7.3 and the deficit performance related to anxiety was 17.47 ± 7.1. The problematic behavior in our population was significantly associated with lifestyle alone, coffee consumption and with serious accidents.

The results of our study identified some risk factors that could lead to poorly adaptive driving behaviors among Taxi drivers. These elements reinforce us in the idea that this population requires special care with a meeting with the doctor.

Ethanol is widely consumed by the world’s population, especially young people as part of their university life. In Tunisia, surveys and studies about consumption of ethanol among students are rare or even exceptional.

To evaluate the extent of the consumption of ethanol among pharmacy students in Monastir University, from the first year to residency, and to define the factors associated to this consumption.

This study was used to collected information about the participants using a questionnaire that covers the different parameters of the consumption of ethanol during student life and the factors influencing this consumption.

154 participants aged 23.61 years +/- 2.63 among them 37.7% were men and 62.3% women. The prevalence of ethanol consumption was 44.8 %. The main reason for dirking was to party (79.2%). The consumption of ethanol was significantly associated with sex (p=0), place of residence (p=0.047), frequency of hang-outs (p=0), sex life (p=0) and students perception of the alcohol-health relationship (p=0). Various health problems were related to the frequency of consumption of ethanol, such as memory problems (p=0.002), violence and injuries (p=0.014).

The findings of this study underline the need to develop specific studies and general population surveys in order to better assess the situation in Tunisia and to put in place appropriate prevention strategies, such as information and awareness campaigns, aimed at reducing or at least rationing the consumption of ethanol.

No significant relationships.

In March 2020,World Health Organization characterized the COVID-19 outbreak as pandemic. This new health situation has created an anxiety-provoking climate among health professionals

To provide risks associated with the exposure of caregivers to COVID-19 for their mental health by studying the prevalence and predictors of post-traumatic stress disorder, anxiety and depression.

Our study was descriptive and analytical cross-sectional, carried out with healthcare in different hospitals in Tunisia, between 13 May until 20 June 2020. An online survey was sent to caregivers. mental health was assessed using 3 scales: PCL-5:measure the symptoms of post-traumatic stress disorder HADS :screen for anxiety and depression. PSQI:see the existence of a disturbance in sleep quality

125 caregivers participated in the survey. The average age was 32 years. The participants were predominantly female (72.8%), married (48%), and had at least one child (39.2%). 28.7% of participants had increased their consumption of coffee, especially anxious people (p = 0.001). Anxiety was retained in 44% and depression in 47.2%. Anxiety was significantly related to sex with (p = 0.039) and affects more women. The consumers of coffee developed more anxiety (p = 0.034) and depression (p = 0.026). 42.4% of participants had presented post-traumatic stress disorder. Three parameters were correlated with post-traumatic stress disorder: young age, having children and fewer years of professional experience. 62.4% of caregivers had a bad quality of sleep

This health crisis had a major impact on the mental health of our heroes. So, we should provide for them with the necessary support.