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Introduction: Emigration has a substantial impact on Tunisia's healthcare sector. Graduates, including medical students at different educational levels, as well as general practitioners and specialists, often choose to emigrate. Some do so to pursue further studies abroad, while others seek careers and settlement primarily in Europe. This phenomenon exerts a significant influence on the quality of healthcare systems in their home countries. Objectives: To evaluate the inclination to emigrate among medical residents employed in Tunisian healthcare institutions and to identify the factors associated with this intention. Methods: This is a descriptive cross-sectional study conducted among medical residents undergoing their training in various healthcare facilities in Tunisia. The study employed an online questionnaire to assess the degree of satisfaction with various aspects of their professional life and the socio-economic situation in the country, as well as their intention to emigrate. Satisfaction levels were measured using a 4-point Likert scale, ranging from "very dissatisfied" to "very satisfied". Results: A total of 50 physicians participated in the survey. Among them, 72% were female, 80% were single, with an average age of 27.72 years at the time of the study. Regarding their professional status, 84% worked in university hospitals, 16% specialized in surgery, 40% specialized in medicine, and 44% were family physicians. The majority were students from the Faculty of Medicine in Sfax (56%), with 30% in Monastir, 8% in Tunis, and 6% in Sousse. The study found that 68% of medical residents expressed an intention to emigrate. Among the participants, 74% were dissatisfied with their working conditions, and 68% were dissatisfied with workplace safety. Additionally, 84% were dissatisfied with their salaries, 40% with their workload, 54% with supervision, and the quality of training provided in their hospitals. The political situation in the country and social security were considered unsatisfactory by 92% and 90% of the participants, respectively. Among the potential reasons studied to explain this emigration phenomenon, working conditions were a factor in 54% of cases, salary in 56%, training in 36%, and quality of life in 56%. Conclusions: The emigration of young Tunisian medical professionals is driven by a range of factors, including working conditions, salaries, training opportunities, and quality of life. To counteract this phenomenon, it is crucial to enhance these aspects in order to retain these talented individuals in the country and thereby bolster the Tunisian healthcare system. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of suicidal behavior in individuals diagnosed with Bipolar Disorder Type 1 is a topic of great concern within the field of psychiatry and mental health research. Bipolar Disorder Type 1 is characterized by extreme mood fluctuations that can contribute to a heightened risk of suicidal ideation, attempts, and completions in affected individuals. Objectives: - To examine the socio-demographic and clinical profiles of Bipolar Type 1 patients admitted to the "C" psychiatry department at Hedi Chaker Hospital in Sfax, Tunisia. - To identify and understand the factors associated with suicidal behavior in this population. Methods: We conducted a retrospective descriptive and analytic study of hospitalized patients suffering from bipolar disorder type 1 in the psychiatry department "C", Hedi Chaker Hospital, Sfax Tunisia from 2021 to 2023. Socioeconomic data and clinical profiles of patients were collected from archived files. Results: The total number of patients was 98, with an average age of 36.74 ± 12.3 years. The majority were single (67%), living with their families (76.5%), jobless (45.9%), and receiving family support (94.9%). In terms of psychoactive substance use, 81.6% have used tobacco, 46.9% have used alcohol, and 34.7% have used cannabis. Concerning family history, 55% of patients had at least one family member being treated for a mood disorder. Among them, 7.1% had attempted suicide, and 6.1% had died by suicide. Concerning the clinical profile of the study population, 28.6% had a personal somatic history. The diagnosis of bipolar disorder was made at the age of 27.52±8.6 years. 11.2% had a comorbid personality disorder with bipolar disorder. The majority of patients were on antipsychotics (95.9%), 84.7% were using mood stabilizers, 33.7% were prescribed anxiolytics, and only 4.1% were on antidepressants. Treatment compliance was poor in 61.2% of cases and 63.3% of patients had a poor insight. Ten percent of these patients had attempted suicide, 50% during a depressive episode, 50% occurring during a depressive episode, 30% during a manic episode, and 40% of attempts were related to discontinuation of treatment. 3.1% had used hanging, and 3.1% had engaged in voluntary drug ingestion as a method of self-harm. None of the suicide attempts necessitated intensive care hospitalization, but 60% of the individuals were admitted to psychiatric care. There was a statistically significant correlation between suicide attempts and a family history of suicide (p=0.049). Conclusions: Bipolar patients face a heightened risk of suicide, which is closely tied to the distinctive attributes of the disorder, including biological factors, thymic decompensation, and psychological aspects. Consequently, managing their condition necessitates a tailored approach, demanding ongoing vigilance for individuals diagnosed with bipolar disorder. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: In an increasingly interconnected world, migration has become a defining characteristic of the 21st century. While immigration offers new beginnings and prospects, it also presents unique challenges, particularly concerning mental health. The experience of migrating can exert pressure on mental health through factors such as acculturation stress, discrimination, and economic hardships. These challenges can, in turn, contribute to the development of mental health issues. Objectives: To study the socio-demographic and clinical profile of immigrants hospitalized in the "C" psychiatry department, Hedi Chaker Hospital, in Sfax, Tunisia. Methods: We conducted a retrospective descriptive study of immigrants hospitalized in the psychiatry department "C", Hedi Chaker Hospital, Sfax Tunisia from 2011 to 2023. Socioeconomic data and clinical profiles of immigrants were collected from archived files. Results: The total number of immigrants hospitalized during these 12 years was 32, with an average age of 28.81 years ±7.8 years, all of them were males, as the psychiatric department "C" only hospitalizes men. All were of African origin, of whom 21.9% (n=7) had Libyan nationality, 15.6% (n=5) had Somali nationality and 12.5% (n=4) had Sudanese nationality. Communication with them was possible in 87.5% of cases, primarily through the native Arabic language in 56.3% of instances. Illegal immigration was the most prevalent form, accounting for 75% of cases. During the immigration process, 18.8% of individuals reported experiencing violence." The majority of hospitalized immigrants were single (71.9%), had a primary school education (37.5%), a low socio-economic level (81.3%), and no profession (59.4%). 21.9% of them had received social assistance, and 59.4% lived in a refugee camp. Psychoactive substance consumption was reported by 53.1% of our study population. Regarding the clinical profile of the population, 21.9% had a history of somatic conditions, 43.8% had a psychiatric history, including 9.4% who had attempted suicide, and 34.4% who had experienced traumatic events since arriving in Tunisia. The primary reason for hospitalization was behavioral disorders in 71.9% of cases and suicide attempts in 15.6%. The most prevalent diagnoses were schizophrenia (50%), and bipolar disorder (18.8%). Upon discharge, 15.6% encountered administrative issues. Conclusions: Hospitalized immigrants exhibit diverse socio-demographic and clinical profiles. These findings underscore the significance of acquiring a deeper understanding of the mental health needs and existing barriers to healthcare within various immigrant communities. This is particularly crucial as immigration continues to be a central focus in Tunisia's public policies and discussions. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Caregivers in the Sfax region, Tunisia, having been at the forefront in the face of the Covid-19 pandemic, were therefore faced with intense stress. It seemed useful and interesting to us to study their adaptation strategies during this period of pandemic. Objectives: The aims of our study were to identify the coping strategies used by Tunisian Healthcare workers (HCW) during the Covid-19 pandemic and to study the links of the different coping strategies with perceived social support and trait anxiety. Methods: A cross-sectional, descriptive, and analytical study conducted among 254 Tunisian HCW working at the Habib Bourguiba and Hedi Chaker university hospitals in Sfax, during period from January 2021 to April 2021. the questionnaire used included an information sheet and three scales; "Social support questionary 6" (SSQ-6), "State Trait Inventory Anxiety Form Y2" (STAI-Y2), and "Ways of Coping Checklist" (WCC). Results: Using the WCC scale, the strategy most used by participants was the problem-focused one (M = 2.98 ±0.53), followed by the emotion-focused strategy (M = 2.65 ±0.58), and that centered on the search for social support (M = 2.64 ±0.59). Using the SSQ-6, the mean score for the availability of perceived social support was equal to 8.91±4.59 and the score mean perceived satisfaction was equal to 28.63±5.84. The prevalence of trait anxiety was 50%, according to the STAI-Y2. Statistical tests showed that problem-focused coping was the strategy most adopted by non-anxious participants. They also showed that the higher the availability of perceived social support, the more the social support-seeking coping strategy was chosen, and the higher the perceived satisfaction with perceived social support, the less the emotion-focused strategy was chosen. Conclusions: It seems necessary to propose a learning program for coping strategies to counter the potential emergence of ineffective strategies and to reinforce the use of effective strategies, in order to improve or maintain optimal well-being of health personnel. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Carbamazepine is effectively used in treatment of bipolar disorder for its thymoregulatory virtues, but it can induce numerous side effects, including skin eruptions that can be severe sometimes. Objectives: To study the relationship between toxidermia and treatment with carbamazepine. Methods: We report the case of a patient who developed a toxidermia following the intake of carbamazepine. Results: Mr. AD, 19 years old, with medical history of diabetes, has been diagnosed with bipolar disorder since the age of 17. He was initially treated with risperidone with an irregular follow-up. He was hospitalized in our department for a manic episode with psychotic features with agitation and refusal of treatment. The patient was put on injectable treatment 15 mg/day of Haloperidol and 20 mg/day of diazepam. After 5 days in hospital, we switched to the oral route, gradually increasing haloperidol doses to 30mg, reducing diazepam doses and introducing carbamazepine for thymoregulatory purposes. Carbamazepine was progressively increased up to a dose of 800mg per day. Fourteen days after the introduction of carbamazepine, the patient presented a generalized rash requiring the discontinuation of this medication. He was treated with an anti-histamine and local corticosteroids, on the advice of dermatologists. In the days following discontinuation of carbamazepine, skin lesions regress and then disappear. Biologically, we observed a rise in eosinophilic polynuclear cells to 580, followed by a gradual decrease after stopping the treatment. A pharmacovigilance opinion was sought, concluding that carbamazepine was responsible for the toxidermia, given the delay in onset and the favorable evolution after discontinuation of the incriminating treatment. Moreover, this undesirable effect is well described in the literature. Hence the contraindication to further use of carbamazepine in Mr. AD. In addition, the patient was put on sodium valproate with good tolerance. Conclusions: Each prescribed drug must be considered as potentially capable of causing cutaneous reactions as an adverse effect. Both the prescriber and the patient must be made aware of this phenomenon. The attitude can be modulated on a case-by-case basis, after specialist advice, depending on the severity of the rash and the disease to be treated. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Tunisian emigrants may consume psychoactive substances in other countries. This community is exposed to sociocultural and legal contexts different from those in Tunisia and the degree of acculturation would tend to increase over time. However, data on the use of psychoactive substances, particularly cannabis, in this particular population are scarce. Objectives: This study aims to determine the profile of Tunisian young adults residing abroad who use cannabis. Methods: We conducted a cross-sectional, descriptive and analytic study. It was carried out in the form of an online survey. We focused on young Tunisians people who have completed their secondary studies at the pilot high school of Sfax and currently residing abroad. Data collection was through Google Forms administred questionnaire. Results: Thirty-five participants were included in our study. Cannabis use behavior affected 48.6% of them (N=17)) and it was done with friends in a festive setting in 88% of cases (N=15). Cannabis use was more common among people who were single (p=0.001), living alone (p=0.047), had a psychiatric history (p=0.032) and hanging out with friends who also smoked cannabis (p=0.032).Cannabis use was also more common among cigarette smokers (p=0.000) and alcohol consumers (p=0.000). It was significantly more common among people who shared erroneous beliefs about cannabis, that it is a mild drug (p= 0.024) and that it does not cause dependence (p= p=0.042). Conclusions: Cannabis use among Tunisian young adults residing abroad seems to be a form of poly-consumption, more common among singles, living alone and having a psychiatric vulnerability. These findings underscore the need for targeted interventions and educational initiatives to address cannabis use within this specific population. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Non-adherence to treatment is a major concern for mental health professionals. Knowledge of prescribed medications can influence patients' willingness to adhere to them. Objectives: The aim of this study was to assess the knowledge of patients with mental disorders about their prescribed medication and to evaluate their attitudes and beliefs toward treatment. Methods: Our quantitative descriptive study involved 52 patients hospitalized in the psychiatric "C" department of the Hedi Chaker University Hospital in Sax between the 23rd and 30 October 2023. Excluded were aggressive patients, those who were unable to communicate, and those who refused to participate. Thirty-nine patients were included. For each patient, we collected sociodemographic, clinical, and disease progression data, as well as information, beliefs, and attitudes concerning the prescribed treatment. Results: The mean age of our patients was 35.49 ± 10.24 years, with an exclusively male sample. Most patients had no occupation (69.2%). Only 10.3% were married. Over half of the patients had achieved primary school (61.5%) and lived in rural areas (64.1%). The mean duration of the mental disorder was 10.69 ± 9.07 years. Patients were hospitalized 3.62 times on average. The most frequent diagnoses were schizophrenia (35.9%) and bipolar disorder (33.3%). More than half of the patients (61.5%) knew the color and shape of the prescribed medication, and 48.2% knew the name and dose. The source of treatment information was mainly doctors (33.3%) and family members (15.4%). Adherence to treatment was poor in 69.2% of cases. The majority of patients denied stopping treatment and 12.8% reported that they stopped treatment because of financial difficulties. Twenty-four patients confirmed that taking the treatment made people see them differently and that they preferred not to reveal they were taking it. Two-thirds of patients reported that the treatment relaxed them (71.8%) but could be stopped when they felt better (69.2%). Conclusions: It is essential for mental health professionals to develop and implement effective intervention strategies that maximize therapeutic impact and reduce the risk of relapse. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Violence against women is a public health problem worldwide and a violation of human rights. It affects women's lives due to its potential short-, medium- or long-term physical and psychological consequences. Objectives: The aim of our study is to explore the link between violence against women and self-esteem. Methods: A descriptive cross-sectional study was conducted from March to August 2023 among Tunisian women consulting in three health care centers in Sfax, Tunisia. We have included women victims of violence (psychological, physical, sexual, and economic). We have used a semi-structured interview and the Rosenberg scale to determine the quality of self-esteem. Results: Among one hundred interviewed women, fifty-four women who had reported being violence victims were included in our study. The mean age of the participants was 44 years with the majority being married (87 %). Only 29.6% had a high school level and 51.9% had a profession. A total of 29.6% had a low socioeconomic status. We found that 79.6% are victims of domestic violence (57.4% being victims of spousal violence). Psychological violence seemed to be the most frequent type (59.3%). Almost all those who were abused (90.6%) experienced psychological (emotional) violence. The mean score of the Rosenberg self-esteem scale was 31.54. Self-esteem was very low in 16.7%, low in 37%, medium in 18.5%, and high in 27.8% of the women. A statistically significant association was found between being a victim of spousal violence and low self-esteem (p=0.032). The semi-structured interview demonstrates that women with low self-esteem are more likely to accept violence. Conclusions: These results justify the implementation of screening and support programs for women victims of violence to improve their self-esteem. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Fear of childbirth is attracting growing interest because of its impact on the experience of pregnancy and on the progress of childbirth and it seems that some women are more susceptible to fear of childbirth than others are. Objectives: Our objective is to identify pregnancy factors that predict the fear of childbirth. Methods: We approached 350 pregnant women consulting at the Gynecology-Obstetrics department of the Hedi Chaker University Hospital of Sfax. We collected their sociodemographic and clinical data. Fear of childbirth was assessed using the French version of the Traumatic Event Scale (TES), adapted to assess fear of childbirth. Results: The mean age of the participants was 28 years (16-41) and the mean gestational weak was 36.27. Half of the participants (53.7%) were nulliparous, and eight reported a history of infertility. The pregnancy was not planned in 61% of cases. As many as 67% of the participants had regular checkups, 50.3% had exaggerated somatic symptoms and 34.3% had pregnancy-related diseases. The mean score for the TES was 48.73 ± 13.72. We found a positive correlation between the TES score and nulliparity (p=0.01), gestational age ≥ 40 weeks (p=0.01), planned pregnancy (p=0.002), exaggerated somatic symptoms (p=0.03), and pregnancy-related diseases (p<0.001). Conclusions: Identification of women at risk for fear of childbirth could help in preparing them before or during pregnancy to improve their childbirth experiences. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Psychological vulnerability and problematic psychotropic drug use among medical residents are critical and intricate areas of study in the field of healthcare and mental well-being. This topic looks into the potential links between the psychological vulnerabilities experienced by medical residents, which are frequently associated with the demanding nature of their profession, and their use of psychotropic drugs in a way that poses problems or risks. Exploring this relationship is critical for understanding the mental health challenges that medical residents face and developing effective strategies to support their psychological well-being. Objectives: to identify the psychological factors linked to problematic psychotropic drug use in medical residents. Methods: We conducted a cross-sectional descriptive and analytical study among Tunisian medical residents between August and September 2022. We used a self-administered questionnaire with a data collection form, the DAST-10 (Drug Abuse Screening Test) scale, and the DASS-21 (Depression, Anxiety, and Stress Scale) in an online survey. Data was analyzed using the 20th version of the SPSS software. Results: The sample consisted of 80 medical residents. Among them, 23.8% (n=19) had reported a previous use of psychotropic drugs, and 15% (n=12) a misuse (without a prescription and/or without following the prescription). The DAST-10 revealed that 6 residents (31.6%) had problematic use of psychotropic drugs. A high level of stress on the DASS-21 scale was associated with a problematic use (p=0.01) and a misuse (p=0.01) of psychotropic drugs. Furthermore, residents with high stress levels were more likely to demonstrate problematic use of psychotropic drugs (p=0.004). Such problematic use was correlated with personal history of anxiety disorders (p=0.01). Furthermore, residents with problematic psychotropic drug use had higher anxiety and depression scores on the DASS-21 scale (p>0.05). Conclusions: Our findings revealed a concerning prevalence of psychotropic drug use among medical residents and an association with high stress levels. This result emphasizes the need for targeted interventions to support young doctors' mental health. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: The psychopathology of female crime perpetrators is not well understood since female criminality rates have remained distinctly lower than male criminality. This study draws on over 20 years of psychiatric expertises to identify sociodemographic, clinical, and forensic characteristics of female perpetrators. Objectives: - To describe the epidemiological and clinical profile of female offenders examined for criminal psychiatric expertise. - Describe the criminological and forensic characteristics of these women. Methods: Retrospective and descriptive study, which focused on 56 criminal psychiatric expertise files of female offenders, examined at the psychiatric department "C" at the CHU Hedi Chaker in Sfax, Tunisia, over a period of 24 years. For each offender, we examined the expert report and the judicial research report. We then transcribed the socio-demographic and clinical information, as well as the criminological and forensic characteristics, onto a pre-established form. Results: The accused women in our study had an average age of 35 years and 06 months, and 67.86% of the cases were under 40 years of age, with an educational level no higher than primary school in 62.5% of cases. They were unemployed in 71.4% of cases. Among the accused examined, 76.8% had mental disorders, including 46.6% with personality disorders, 16.3% with intellectual disability, 16.3% with bipolar disorder, 9.3% with depressive disorder, 9.3% with psychotic disorder, and 2.3% with substance use disorder (anxiolytic). We recorded 55.4% offences against persons, including 37.5% homicides and attempted homicides, and 44.6% offences against property, including 23.2% thefts. Dementia in the legal sense was identified in 30.4% of cases. Bipolar disorder accounted for 41.1% of legally demented subjects. Conclusions: It emerges that the profile of the female criminal is that of a woman under 40, with a low educational and economic level, and most often with an antisocial personality or intellectual disability. It would therefore be important to step up primary prevention work by better educating these at-risk women and to combat the factors contributing to dangerousness among the mentally ill by optimizing their psychiatric care. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: The coronavirus pandemic has affected mental health since its outbreak in 2019 and several studies have revealed that obsessive-compulsive disorder (OCD) patients were adversely affected. Objectives: The aim of our present report is to study the impact of the coronavirus infection on OCD. Methods: We illustrate a case of new emerging obsessions and compulsions after a COVID-19 infection in a patient consulting at the Psychiatry C department of the Hedi Chaker University Hospital. Results: Mr. HB first presented in our outpatient unit of the Psychiatry C department at the age of 32. His medical history was unremarkable except for a COVID-19 infection in June 2022 that did not cause any organic complications. His family history was negative without neurological and psychiatric diseases. Further history revealed that OCD symptoms already started before his infection with COVID-19. At that time, he suffered from compulsions with the urge to constantly wash his hands and check rituals, but his symptoms were not severe enough to make him seek a psychiatric consult or treatment. However, since July 2022, soon after his infection with COVID-19, he suffered from new obsessions and compulsions, he would spend hours calculating all the numbers he sees and counting the number of letters in the words he came across. Non-surprisingly, OCD symptoms caused relevant problems in social life, and at work, he had difficulties concentrating and working. Due to his symptoms, he had neglected hobbies, avoided social contact, spent less time with his family, and even had suicidal thoughts. Therefore, pharmacotherapy with clomipramine was initiated with a maximal dose of 150 mg/d. Because of adverse events and lack of efficacy, he stopped medication and decided to consult our department to seek a different treatment. Therefore, sertraline was started at the dose of 50 mg/d along with psychotherapy. Conclusions: People with OCD are likely to be more susceptible to the mental health impact of COVID-19. Responses to the pandemic are not only associated with an increase in all Obsessive-Compulsive (OC) symptoms and their severity but also the emergence of new types of obsessions and compulsions. Consequently, therapists should consider the effects of the pandemic on all OC symptom dimensions and adjust their treatment plans accordingly. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: The evaluation of manic behavior with later onset is crucial, as various organic factors such as medications, infections, metabolic disturbances, tumors, and epilepsy can serve as potential etiological causes. While not universally observed, most studies indicate a connection between late-onset mania and neurological disorders like neurosyphilis. Objectives: Our study aims to investigate the relationship between late-onset mania and neurosyphilis. Methods: In this paper, we present a case of neurosyphilis presenting exclusively with symptoms of mania. Results: A 72-year-old Tunisian woman with no prior medical or psychiatric history was referred to the psychiatric emergency room due to alterations in her mental state and behavior over the past ten days. During the psychiatric assessment, she displayed increased motor activity, fluctuating emotions, and rapid flow of ideas. The general physical examination yielded no notable findings. The serum Venereal Disease Research Laboratory (VDRL) test returned a strongly positive result (+++), and the TPHA examination confirmed a positive result at a titer of 1/60. In the serologic analysis of cerebrospinal fluid, VDRL was also positive, thereby confirming the diagnosis of neurosyphilis (NS). The diagnosis of mania secondary to a medical condition was established. The patient was treated with ceftriaxone and antimanic medications, resulting in a significant improvement in her psychiatric symptoms within a few days. Conclusions: This case underscores the importance of conducting serologic testing for syphilis in patients who present with manic symptoms, experience a late-onset mental disorder, and have no prior history or family history of affective disorders. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: While postictal mania is a well-recognized clinical condition, it has received less research attention compared to other postictal manifestations. Objectives: Drawing upon an analysis of a case report that underscores the clinical and therapeutic challenges associated with comorbid epilepsy and mania, a literature review was carried out to investigate the connection between these two disorders. Methods: We illustrate a case of comorbidity between mania and epilepsy and provide a concise review of the literature summarizing the key characteristics of this association. Results: This case pertains to Mr. M, a 44-year-old male with a history of frontal epilepsy characterized by secondary partial generalization, which was partially controlled with sodium valproate. He was admitted to our service due to acute agitation following a loss of consciousness lasting a few minutes. Upon admission, the patient exhibited symptoms of mental confusion. A neurological examination did not uncover any abnormalities. Brain computed tomography revealed mild frontal atrophy. Video electroencephalography conducted during the interictal period and outside the episodes of confusion did not reveal any abnormalities. The patient was restarted on sodium valproate (20 mg/kg/day) and clonazepam (2 mg/day). Following a lucid interval of ten days, the patient started to manifest psychiatric symptoms, which included irritability, hostility towards his spouse, increased talkativeness, thought pressure, and an unusual sense of familiarity, raising suspicion of post-ictal mania. Conclusions: Based on this clinical case and the existing scientific literature, post-ictal mania occupies a distinct position among the mental disorders observed in the post-ictal period. Therefore, clinicians must be aware of these conditions to facilitate accurate diagnosis and appropriate management. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

Introduction: Orthorexia and exercise addiction can lead to serious health problems, such as malnutrition and exercise-related injuries. Objectives: The aims of our study were to assess the prevalence of exercise addiction and orthorexia nervosa in Tunisian students at the Institute of Physical Education in order to investigate the relationship between these different health dimensions. Methods: An anonymous self-administered questionnaire was distributed to students in the Sfax and Gafsa sports sections during March 2023. The orthorexic tendency was assessed using the ORTO-15 questionnaire. An ORTO-15 score below 40 points indicates orthorexic tendencies. The Exercise Addiction Inventory (EAI) was used to study exercise addiction Results: In our study, 240 students were included. Mean scores on the ORTO-15 and EAI scales were 38.6 ± 8 and 16.6 ± 4.1 respectively. Participants at risk of exercise addiction had a statistically significant tendency towards orthorexia (p<0.001). Among the students, 82.5% had engaged in regular physical activity at a gym in the last two years. The reasons given by students for going to the gym were muscle strengthening (57.9%) and preparation for a sporting competition (37%). Among students taking part in sports activities at the gym, the mean ORTHO-15 score was significantly lower among those doing so to prepare for a sports competition (p=0.005). Participants who believed that they were addicted to sport had a statistically greater tendency towards orthorexia (p=0.012). Conclusions: Our study revealed an association between addictive exercise and orthorexic eating in Tunisian athlete students. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]