ABSTRACT
BACKGROUND: Burnout is a professional psychological chronic stress-induced syndrome defined by three dimensions: emotional exhaustion, depersonalization, and low personal accomplishment. This syndrome concerns all professions but especially healthcare staff. Numerous studies have attempted to document the impact of work activities on the doctor's mental health. According to the literature, junior doctors are more vulnerable to develop this syndrome. AIMS: Are to determine the prevalence of severe burnout among residents of different specialties: anesthesiology, general surgery, emergency medicine, psychiatry, basic sciences. The secondary end points are to analyze risk factors, causes and consequences associated with burnout. METHODS: A cross-sectional study conducted among medical residents working in hospitals located in the governorates of Tunis. Three instruments were used: an anonymous self-administered questionnaire, Maslach Burnout Inventory (MBI) to assess burnout, and Abstract Beck Depression Inventory to evaluate the intensity of depression. Severe burnout was defined as a severely high level of both emotional exhaustion and depersonalization associated with a severely low level of personal accomplishment. RESULTS: A total of 149 participants (response rate=76.8%) participated in the survey. Among participants, 17.14% (n=26) had a severe burnout. The emergency medicine residents had the highest rate of emotional exhaustion and depersonalization and severe depression. Overall, resident respondents, 31% (n=46), had moderate to severe depression. Among stress factors, those significantly correlated to burnout were: lack of hobbies (P<0.001), bad job conditions (P=0.031), poor conditions of the workplace (P=0.046), relationship problems in workplace (P=0.01), work-family conflicts (P<0.001). The consequences of occupational stress associated with burnout were: Antecedents of specialty change (P=0.017) and desire for a specialty change (P<0.001). A significant correlation between depression and severe burnout was not found. CONCLUSION: Medical residents in all specialties are at risk of burnout. Nevertheless, this study revealed that some specialties are more exhausting, which is consistent with the results reported in the literature. Moreover, it is shown that several stress factors as well as many consequences are related to severe burnout, which is in agreement with numerous studies. However, results between different studies are disparate.
Subject(s)
Burnout, Professional/epidemiology , Burnout, Psychological/epidemiology , Internship and Residency/statistics & numerical data , Students, Medical/statistics & numerical data , Adult , Cross-Sectional Studies , Depersonalization/epidemiology , Female , Humans , Male , Physicians/psychology , Physicians/statistics & numerical data , Prevalence , Stress, Psychological/epidemiology , Students, Medical/psychology , Tunisia/epidemiologyABSTRACT
BACKGROUND: Unlike schizophrenia, the impact of gender on the criminality of patients with bipolar disorder has received little attention. AIM: To estimate the sex ratio in relation to acts committed by forensic bipolar patients and evaluate the impact of gender on the characteristics of this crime. METHODS: A comparative study by gender, conducted at the psychiatric hospital Razi has included all patients with bipolar disorder hospitalized between 1990 and 2010 after being relaxed for mental illness, owing to the Tunisian penal code. RESULTS: The total number of patients was 36 and the sex ratio of 3.5.A suicide history was four times more common in women. Alcohol abuse was found only in men. Relapses were more frequent in women (3.06 I year against 1.14 I year, p = 0.02). Rapid cycling and comorbid anxiety were noted only in female patients. Filicide and prostitution were committed exclusively by women, economic crimes and sexual assaults were the preserve of men. The male offenses were more impulsive and unpremeditated (p = 0.04). CONCLUSIONS: Although sex ratio is in favor of men, women's representation in the violence induced by bipolar disorder is significant, resulting, particularly during depressive phases, by serious and deadly acts. Preventive measures of acting out in bipolar patients must be supported and especially adapted to the genre
