Main objective was to assess the prevalence of burnout in Tunisian primary care practitioners working in public sector in the region of the Cap Bon. Secondary objectives were to determine the risk factors and the consequences associated with this syndrome.

transversal study using four scales: Anonymous auto questionnaire elaborated by the medical team, the Maslach Burnout Inventory (MBI), the Beck Depression inventory (BDI) and the state-trait anxiety inventory (STAI). The MBI explores the three dimensions of Burnout: emotional exhaustion, depersonalization and reduced personal accomplishment. In our study, the Burnout was defined by the presence of two or three pathological dimensions.

113 questionnaires were exploitable (85.6% of the sample). The results of the MBI showed that one third of doctors suffer from Burnout and 7.1% have severe attaints. 35% of the doctors had high score of emotional exhaustion, 21% had high depersonalization and 40% had a low score of personal accomplishment. The Burnout was significantly associated with depression (p < 0.001), suicidality (p=0.023) and anxious temperament (p< 0.001). On the other hand, a continued medical education protected significantly against the Burnout (p=0.003). Professional exhaustion was significantly related to the wish of reconversion (p=0.023) and to relational difficulties with patients and colleagues. The solutions proposed were the increase of the number of doctors and a better education of medical students in general medicine.

Studying the social conflict among inhabitants of small settlements owing to extreme situations.

Social-psychological investigation for revealing interpersonal and intergroup (victims and nonvictims) conflicts among in townsfolk of Sydybyl (Yakutia) and Beslan (North Ossetia) after disaster with death of children.

It was shown that the basic psychological need of persons who loss their relatives during a disaster is a search of guilty of tragedy. In consequence of this, occurs the stratification of society with apportionment of such groups as “victims” and “guilty”. The “victims” additionally mark out the group of “light victims” and accuse them of insufficient efforts to rescue of children of “victims”. It was suggested that the persistent search of guilty represents a form of psychological defense against the unbearable feeling of their own guilt towards died children. The universal (non-conditioned by ethnic or cultural factors) character of described phenomena was emphasized. It was marked that the social conflict (named by author as indigenous) deteriorates the social and economic consequences of disaster.

The indigenous conflict tends to persistence and passes the certain phases, final of which is characterized by a high level of neurotic diseases in the opulation and migration of an efficient part of the population.

Asthma is a mayor public health issue; its prevalence has increased in recent decades world wide. However, focus on biological risk factors has not fully explained this trend. A mounting body of research evidence suggests that psychosocial distress is likely to be a factor contributing to the development of asthma.

To estimate the effect of psychosocial distress on asthma mortality rate at the aggregate level.

Trends in age-adjusted, sex-specific suicide (as an integral indicator for psychosocial distress) and asthma mortality rate in Russia from 1956 to 2005 were analyzed employing an ARIMA analysis in order to asses bivariate relationship between the two time series.

Time series analysis indicates the presence of statistically significant association between the two time series for male. The association between the two time series for female also positive, however, statistically not significant.

The findings of the present study add to the growing number of studies linking psychosocial distress to asthma expression and mortality. This paper presents new epidemiological evidence that supports psychosomatic concept of asthma.

Due to our fear of extinction or annihilation, there is a great deal of preoccupation with the subject of death, through which we attempt to learn to feel more at ease with the concept, and allowing us to cope with our fear of death.

The study assumptions seek to emphasize the correlations between:

1. A. Demographic characteristics and anxiety of death and dying;

2. B. Inner - personality characteristics and death and dying anxiety variable; and

3. C. Intrapersonal characteristics and death and dying anxiety.

Findings indicate that the war increased the death and dying anxieties especially among those elderly women and those who live within nursing homes. In general elderly people with a high level of self-evaluation and sense of mastery will experience lower levels of death and dying anxieties.

In spite of age, experience and knowledge, war has a powerful influence on elderly people. The phenomena in which innocent citizens became more and more involved in politics violence must be in front of policy makers.

Study concentrations of steroid and thyreoid hormones in patients with neurotic, stress-related and somatoform disorders.

35 patients with dissociative (conversion) disorders (ISD-10, F44), 29 patients with adjustment disorders (ISD-10, F43.2) and mentally healthy persons (27 persons) were investigated. Immunofermantal analysis for definition of concentration of steroid and thyreoid hormones were carried out.

We have observed statistically significant increased level of cortizol (p< 0,05) in patients with adjustment disorders (635,04±48,69 nmol/l) in comparison with control and patients with dissociative (conversion) disorders (444,97±24,53 nmol/l and 443,13±23,00 nmol/l accordingly). The statistically significant the lowered maintenance of dehydroepiandrosteronum is characteristic for patients with adjustment disorders in comparison with control and patients of another group (3,9±0,26; 6,35±0,62 and 6,69±0,50 mkmol/l accordingly, p< 0,05). For patients with dissociative (conversion) disorders is characteristic the statistically significant increased level of triiodthyronin (1,71±0,12 nmol/l), in patients with adjustment disorders and mentally healthy persons this metric composed 1,26±0,02 nmol/l and 1,34±0,04 nmol/l accordingly. The level of thyroxin for the persons with dissociative (conversion) disorders differ from values of control and patients with adjustment disorders (23,68±2,07 pkmol/l; 17,64±1,43 pkmol/l and 14,69±0,53 pkmol/l accordingly, p< 0,05).

For patients with adjustment disorders is characteristic the statistically significant increased level of cortizol and the lowered maintenance of dehydroepiandrosteronum. Dissociative (conversion) disorders are formed in conditions of the raised maintenance thyreoid hormones and the physiological maintenance of steroid hormones.The investigation supported by project of RHSF №06-06-00691а, №07-06-95673и/М and №08-06-00284а.

The main objective of this study was to verify if the Lifestyles are related with the type of Personality of the firefighters. Another objective was to verify if stress is related with the Lifestyles adopted.

This was a transversal study applied to 146 Firefighters of Leiria, with ages between the 17 and 60 years (44 female and 102 the male). We used the NEO-Pi-R to analyze Personality and the Lifestyles Appraisal Questionnaire.

We found a significant statistical correlation between the Lifestyle Part I (risk factors) and the Neuroticism, that suggests that these citizens tend to have a bigger risk to developing illnesses. They present higher values of concern, nervousness, hypochondriacs and they have more disability answers of coping. They tend to be emotionally unsafe, revealing, sometimes, feelings of incompetence. They also show sadness, fear, embarrassment, anger and guilt. We also found significant statistical between the lifestyle Part I (risk factors) and the Lifestyle Part II (Stress). Indicates that a higher risk of developing illness is related to higher levels of stress. It was verified that the citizens present high factors of risk for their health and that this factor helps to increase the loss of control of the perception of stress.

This study was examination by Telepsychiatry and E-consalting of war related posttraumatic stress disorder (PTSD).

The subjects were 114 male psychiatric patients by Telepsychiatry and e-consulting with war-related PTSD by videoconferencing via broadband ADSL and WADSL by 768 kbps. Posttraumatic stress syndrome-PTSS scale and 20-item Zung self rating scale was used to assess state measures of symptom severity.

The symptoms of prolonged PTSS (posttraumatic stress syndrome) with duration between six moths and two years had been founded at 84(73,68%) and 30(26,32%) of patients had no PTSS. Symptoms of depression had been found at 72(63,15%) patients. The enduring personality exchange after catastrophic expiriense (F62.0), had been found at 15(13,15%) patients (P< 0.01); symptoms of depression had been found at 54(47,36%) patients after two years.

Telepsychiatry service and e-consalting it is able to serve not only PTSD but also wide range of other patient population. Continued examination and follow-up evolution of PTSD symptoms by Telepsychiatry service may be important in predicting the eventual development of depressive symptoms and precipitation of F62.0 enduring personality exchange after catastrophic expiriense in the war related PTSD.

This study was a 15-year follow-up examination. Many patients with F 62.0 and post traumatic stress disorder (PTSD) have symptoms of depression. The authors’ objective is to analyze symptoms of depression in F 62.0 and PTSD.

The subjects were 200 male psychiatric patients at a Clinic of psychiatry medical center Banjaluka and psychiatry department of with war-related PTSD. Post traumatic stress syndrom-PTSS scale and 21-item Hamilton Rating Scale for Depression-HAMD was used to assess state measures of symptom severity; from 3 months to 15 years after returning from the war.

The symptoms of prolonged PTSS (with duration between six moths and two years) had been founded at 54%, and 32% of patients had no diagnosis PTSD. The enduring personality change after catastrophic experience (F 62.0) had been found at 14% patients (with duration more than two years), 19% met HAMD Diagnostic Criteria for major depressive disorder.

The enduring personality exchange F 62.0 had been found at 8% patients and 16% met HAMD Diagnostic Criteria for major depressive disorder 15 years after returning from the war.

The statistical relationship between level of combat exposure and PTSD symptoms at 15 years, suggests that it may take time for the consequences of traumatic exposure to become apparent. Moreover, degree of exposure may be important in predicting the eventual development of symptoms and precipitation of F 62.0 enduring personality exchange. Continued follow-up will address the evolution of PTSD symptoms in war related PTSD.

To assess healthy-related quality of life and psychosocial adjustment in children with newly diagnosed cancer and their parents immediately and 6 months after diagnosis and treatment of cancer.

A prospective, case control study was conducted on eighty-nine children with newly diagnosed cancer, aged between 6 months to 16.7 years (mean, 8.2 years), and ninety healthy children of matched age group and social background. The children were assessed with the Child Behavior Checklist (CBCL), and the Parenting Stress Index (PSI) and the SF-36 questionnaire were administered to their parents immediately after diagnosis of cancer, 3 months after chemotherapy, and 6 months after chemotherapy.

No matter at the period immediately after diagnosis of cancer, 3 months or 6 months after starting chemotherapy, the parents of children with cancer scored significantly worse on every domains of SF-36 except body pain and every subscales of PSI except distractibility/hyperactivity and attachment when compared with the control group. The cancer group scored consistently lower on all CBCL syndrome scales than the control group, with anxiety, depression and body pain being significantly different. After starting chemotherapy, the parents reported improved scores on quality of life and decreasing parenting stress in both parent and child domains since 3 months or 6 months after starting chemotherapy.

Considerable distress was experienced by both children with newly diagnosed cancer and their parents during the period immediately after diagnosis. However, parents can adjust gradually since 3 months after starting chemotherapy and experience improved quality of life.

The primary purposes of this study were 1) to examine relationships among stress, coping and comorbidity and 2) to test the interaction effect of comorbidity.

Hemodialysis imposes a variety of physical and psychosocial stressors that challenge patients. Comorbidity is a risk factor for many health outcomes. Research on how comorbidity influences the relationship between coping and stress is limited.

In this cross-sectional study using face to face interviews, we interviewed 2642 hemodialysis patients fifteen years or older on dialysis for at least 3 months from October 2002 to January 2003. The Hemodialysis Stressor Scale measured stressors and the Jalowiec Coping Scale were used to measure coping strategies. A hierarchical regression was used to analyze the data.

Hemodialysis patients with comorbidities were found to have higher levels of stress. Comorbidity had a moderating effect between choice of problem-oriented responses and isolated thoughts as coping strategies. These findings show that hemodialysis patients with comorbidities often choose positive coping strategies.

HD patients with comorbidity have a higher stress scores than those without comorbidities. Comorbidity not only has a direct impact on stress but also has a moderating effect on the relationship between coping and stress. Therefore, taking into account the comorbidity factor became very crucial when assessing the HD patients’ level of stress.