[Addiction to psychoactive substances among resident physicians in Morocco: A multicenter cross-sectional study]. / Addiction aux substances psychoactives chez les médecins résidents au Maroc : étude transversale multicentrique.

Introduction Substance use among resident physicians is an underestimated, poorly understood, and serious problem because of its negative consequences for the health of physicians and also for the health and safety of the patients in their care. Objective To estimate the prevalence and identify factors associated with addictive behaviors among resident physicians at different university hospitals in Morocco. Method We conducted a multicenter cross-sectional descriptive and analytical study involving resident doctors from the 7 university hospital centers in Morocco. Resident doctors were invited to participate voluntarily in the study by completing an anonymous self-questionnaire created on Google Forms and sent via email. Results The questionnaire was completed by 310 resident physicians, representing 11.07% of the total population of resident physicians in Morocco. Among the participants, 16.1% (n=50) reported consuming one or more psychoactive substances, including 11.1% (n=37) for tobacco, 10% (n=31) for alcohol, and 6.1% (n=19) for cannabis. The consumption of ecstasy and cocaine was observed in 0.7% (n=2) for each substance. Additionally, 11.9% (n=37) of resident physicians had psychiatric disorders, and 3.2% (n=10) had attempted suicide at least once. The consumption of psychoactive substances among resident physicians was statistically significantly associated with the male gender (4.59 [2.20-9.57]; p=0.000), as well as with surgical specialty (0.48 [0.26-0.88]; p=0.017). Conclusion At the end of this work, we found that the use of psychoactive substances is frequent among resident doctors, which explains the need for preventive measures and appropriate management.

The Epidemiological, Clinical, and Therapeutic Profile of Bipolar Patients in Eastern Morocco.

INTRODUCTION:  Bipolar disorder is a severe psychiatric disorder. The objective of our study is to describe the epidemiological, clinical, and therapeutic profile of patients followed for bipolar disorder in this hospital. MATERIALS AND METHODS: This is a cross-sectional, descriptive study conducted over a period of two years within the mental health and psychiatric diseases department of the Mohammed VI University Hospital in Oujda, Morocco, including 206 patients followed for bipolar disorder on an outpatient basis or hospitalized in one of the departments of the hospital. RESULTS: We included in our study 206 patients with an average age of 37.34+/-12.53 and a male predominance. About 17% of our patients reported a personal medical history and 18.4%, a personal surgical history. Regarding the family history, 40.3% have a medical and surgical history and 63.1%, a psychiatric family history. The consumption of psychoactive substances is present in 49.5% of our patients. About 26.7% reported psychological trauma during childhood. Our patients have reported a history of suicide attempts with a prevalence of 26.6% in several settings: depressive (15%), delusional (5.8%), hallucinatory (3.9%), and anxious (1.9%). Several means were used during these suicide attempts, in particular, defenestration (40%), drug ingestion (36.4%), caustic ingestion (16.4%), strangulation (16.4%), and hanging (10.9%). CONCLUSION:  It is important to develop a personalized approach to the patient wherever possible and, if necessary, to involve other specialists in diagnosis and treatment.

Sertraline-Induced Galactorrhoea: A Case Report.

Patients taking various treatments frequently report galactorrhoea as a side effect. Psychotropic drugs, especially neuroleptics, are among the treatments most likely to cause this effect. Conventional tricyclic antidepressants rarely cause galactorrhea. The advent of new selective serotonin reuptake inhibitor (SSRI) antidepressants purported to reduce such side effects. We report the clinical case of a patient with galactorrhoea on Sertraline as well as our therapeutic approach in light of data from recent scientific literature.

Prevalence and factors associated with suicide attempts among Moroccan patients with schizophrenia: cross-sectional study.

Suicide is an important cause of death among patients affected by schizophrenia. The lifetime prevalence is 10-15%. The identification of factors associated with suicide attempts will help to identify preventive and therapeutic strategies to reduce the toll of suicide. Aims: The purpose of this study is to investigate the prevalence of suicide attempts and their sociodemographic and clinical characteristics in Moroccan patients with schizophrenia. Materials and methods: This is a cross-sectional study of patients admitted to our Hospital of Psychiatry in Morocco, between year and year, with adiagnosis f schizophrenia. Results: In our sample (n=304), 65 (21.4%) had attempted suicide. Suicide attempts were significantly and positively associated with a family history of bipolar disorder, comorbidity with a substance use disorder, a relatively short duration of treatment, poor adherence to medication, and severe general, positive, and depressive symptoms. Conclusion: The prevention of suicide risk requires the effective management of depressive and addictive comorbidities, the reduction of schizophrenia symptoms through appropriate treatment and an effort to improve adherence.

Prevalence of and Risk Factors for Suicide Attempts Among Patients With Severe Psychiatric Disorders in Eastern Morocco.

Background: Suicide attempts are common in patients with severe psychiatric disorders; however, they are rarely studied in this population. Aims: To investigate the prevalence and risk factors associated with suicide attempts among patients with severe psychiatric disorders. Method: This is a cross-sectional study of patients admitted to the Mohammed VI University Hospital of Psychiatry in Oujda, Morocco. Results: A total of 250 patients with a psychiatric disorder were recruited in this study. Among these, 78 cases (31.2%) had a personal history of suicide attempts. A personal history of suicide attempt was significantly higher among women compared to men (45.5% vs. 27.2%, p = .0099). The most common method of suicide attempts was jumping from heights (31%). Patients with a personal history of suicide attempts had a significantly higher prevalence of alcohol consumption (p = .0063), family history of psychiatric disorders (p = .002), family history of suicide attempt (p = .00004), and family history of suicide (p = .018) compared to those who had never made suicide attempts. Limitations: As suicidal behavior is highly stigmatized in Morocco, the number of patients who have made a suicide attempt may be underestimated. Conclusion: Our findings justify the need to provide specialized support to psychiatric patients with risk factors for suicide attempts.

A very rare case of priapism under aripiprazole in a patient followed for bipolar disorder: A CARE-compliant report.

INTRODUCTION AND IMPORTANCE: Priapism is a urological emergency characterized by abnormally prolonged, painful and irreducible erection. It occurs without a sexual stimulation and habitually exceeds 6 h. About a half of iatrogenic priapisms are believed to be associated with antipsychotics. Until to date, very few cases of aripiprazole-associated priapism were reported. CASE PRESENTATION: In this case report, we present the clinical findings of a 40-year-old patient that developed priapism after treatment with aripiprazole after his hospitalization for an episode of clinical mania following treatment discontinuation for bipolar I disorder. The management was successful and priapism was resolved spontaneously. CLINICAL DISCUSSION: Despite its low affinity to alpha-1 adrenergic receptors, aripiprazole may be associated with priapism. Several potential factors involved in the pathogenesis of this adverse event have been reported in the literature including history of priapism in a different class of neuroleptics and consumption of psychoactive drugs which are the principal factors found in our case. CONCLUSION: Priapism may occur even during treatment with antipsychotics that have a low affinity to alpha1-adrenergic receptors. All patients on antipsychotics should be informed about the risk of this rare but serious adverse event.