Search

Abstract Background In Morocco, no epidemiological study has been conducted to show the current prevalence of mental disorders in the general population. The aim of the present study was to assess the prevalence and comorbidity of anxiety disorders in Moroccan subjects. Methods We used cross-sectional study, with a representative sample of Casablanca city. Direct interviews used the Mini International Neurpsychiatric Interview in its validated Moroccan Arabic version Results Among 800 subjects, 25.5% met criteria of at least one current anxiety disorder: Panic Disorder (2%), Agoraphobia (7.6%) Social phobia (3.4), Obsessive Compulsive Disorder (6.1%), Post Traumatic Stress Disorder (3.4%), Generalized Anxiety Disorder (4.3%) Conclusion The results are generally similar to those of Western countries. Future studies need to replicate these results and to concentrate on their impact on the quality of life and the cost of such conditions in the community. more...

Introduction: schizophrenia is a chronic, disabling, and serious disease. It represents a challenge because of its prevalence and its consequences in terms of morbidity and mortality for patients, but also for their families and society. Patients often fail to adhere to their treatment, and this has a severe negative effect on the prognosis of the disease. Thus, the identification of the predictive factors influencing this compliance is very important for adequate management and a favorable evolution. The aim of the study is to assess the predictive factors of non-adherence in patients with schizophrenia., Methods: a cross-sectional study of 320 patients diagnosed with schizophrenia according to the DSM-5 criteria, was conducted at the University Psychiatric Centre of Casablanca, Morocco. Epidemiological, clinical, and therapeutic data were collected using a hetero-questionnaire, while medication adherence was assessed using the Medication Adherence Rating Scale (MARS). The positive and negative symptoms scale (PANSS) was used to assess the severity of symptoms in patients with schizophrenia., Results: in our study, the total sample comprised 320 (100%) patients, classified into two groups: 82 (25.62%) were categorized as adherent, while 238 (74.38%) were non-adherent, and 72% were male. The non-adherent group was young (p=0.003), and a significant proportion had no educational background (p=0.015), lived alone (p=0,001), in urban areas (p=0.031), non-regular follow-up (p=0.045) and had a toxic history (p=0.0001), early age of onset of the disease (p=0.002). Moreover, this group exhibited more severe schizophrenic symptoms (p=0.02), lacked insight into their condition (p=0.046), and predominantly used typical antipsychotics (p=0.019) with a high frequency of intake (p=0.0001). Sedation emerged as a predominant side effect (p=0.036) of treatment. Notably, a high frequency of hospitalizations (p=0.005) exhibited a strong association with medication non-adherence. The mean age of the sample was 32.9 years (standard deviation: 10.8), with a mean age of disease onset reported at 25.5 years (standard deviation=4.9)., Conclusion: this study highlights the prevalence of non-adherence among patients with schizophrenia, with significant associations observed with demographic factors, the severity of symptoms, treatment patterns, and hospitalization frequency, emphasizing the urgent need for tailored interventions to enhance medication adherence and improve patient outcomes in managing schizophrenia., Competing Interests: The authors declare no competing interests., (Copyright: Imane Salihi et al.) more...

Precipitation during the viral inactivation, neutralization and depth filtration step of a monoclonal antibody (mAb) purification process can provide quantifiable and potentially significant impurity reduction. However, robust commercial implementation of this unit operation is limited due to the lack of a representative scale-down model to characterize the removal of impurities. The objective of this work is to compare isoelectric impurity precipitation behavior for a monoclonal antibody product across scales, from benchtop to pilot manufacturing. Scaling parameters such as agitation and vessel geometry were investigated, with the precipitate amount and particle size distribution (PSD) characterized via turbidity and flow imaging microscopy. Qualitative analysis of the data shows that maintaining a consistent energy dissipation rate (EDR) could be used for approximate scaling of vessel geometry and agitator speeds in the absence of more detailed simulation. For a more rigorous approach, however, agitation was simulated via computational fluid dynamics (CFD) and these results were applied alongside a population balance model to simulate the trajectory of the size distribution of precipitate. CFD results were analyzed within a framework of a two-compartment mixing model comprising regions of high- and low-energy agitation, with material exchange between the two. Rate terms accounting for particle formation, growth and breakage within each region were defined, accounting for dependence on turbulence. This bifurcated model was successful in capturing the variability in particle sizes over time across scales. Such an approach enhances the mechanistic understanding of impurity precipitation and provides additional tools for model-assisted prediction for process scaling., (© 2024 American Institute of Chemical Engineers.) more...

Introduction: Cannabis use impairs cognitive performance in healthy subjects; several studies have shown improved cognitive outcomes in schizophrenic patients using cannabis. The aim of this study was to evaluate the effects of cannabis use on cognitive function in Moroccan patients with schizophrenia who were cannabis users., Method: Two groups were recruited in a Moroccan University Psychiatric Centre. Fifty patients diagnosed with schizophrenia according to the DSM-V who were cannabis users (SZ CANN +) and forty-nine patients diagnosed with schizophrenia according to DSM-V who do not use cannabis (SZ CANN-). Cognitive functioning was assessed using the CogState neuropsychological battery., Results: The results of the study suggest that SZ CANN- patients performed better in the test of psychomotor function, attention and verbal memory. While SZ CANN+ patients performed better in the test of working memory, visual memory and emotional recognition. We found no relationship between SZ CANN+ patients and SZ CANN- patients concerning executive function., Conclusions: Our results suggest that cannabis use may have different effects on neurocognitive functioning. It is associated with disorders of psychomotor function, attention and verbal memory. So, it is associated with an improvement in working memory, visual memory and emotion recognition., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 Published by Elsevier Inc.) more...

Schizophrenia (SCZ) is a psychiatric disorder that alters both general and social cognition. However, the exact mechanisms that are altered remain to be elucidated. In this study, we investigated associative learning (AL) and facial expression recognition (FER) in the same patients, using emotional expressions and abstract images. Our main aim was to investigate how these cognitive abilities are affected by SCZ and to assess the role of mere social presence, a factor that has not been considered before. The study compared the behavioral performance of 60 treated outpatients with SCZ and 103 demographically matched healthy volunteers. In the AL task, participants had to associate abstract images or facial expressions with key presses, guided by feedback on each trial. In the FER task, they had to report whether two successively presented facial expressions were the same or different. All participants performed the two tasks under two social context conditions: alone or in the presence of a passive but attentive audience. The results showed a severe learning impairment in patients compared to controls, with a slight advantage for facial expressions compared to abstract images, and a gender-dependent effect of social presence. In contrast, facial expression recognition was partially spared in patients and facilitated by social presence. We conclude that cognitive abilities are impaired in patients with SCZ, but their investigation needs to take into account the social context in which they are assessed., Competing Interests: The authors declare having no conflict of interest., (© 2023 The Authors. Published by Elsevier Inc.) more...

Introduction: The Ibn Rochd CHU is a tertiary care structure that provides care for the most severe cases of COVID-19 requiring hospitalisation in intensive care. The objective of study is to describe the complementary medical and psychological care of patients with COVID-19 in the endocrinology department after a stay in intensive care., Patients and Methods: This is a descriptive observational study of patients transferred from the intensive care unit to the endocrinology service following a COVID-19 infection during the period from 17 April 2020 to May 26, 2020. Clinical characteristics of the patients and complications related to COVID-19 infection were studied; a nutritional assessment using the MNA nutritional status assessment questionnaire; psychological assessment using quality-of-life questionnaires (Hamilton depression and anxiety, HAD, SF36, PCLS); a treatment satisfaction questionnaire (TQCMII) and an assessment of patient autonomy by the ADL score., Result: Our study included 41 patients with an average age of 55 years (19-85 years), a sex ratio M/F of 1.05, 43.9% were diabetic, 34.1% hypertensive, 4.9% asthmatic and 5% obese, and 51.2% were severe and critical cases. The average ICU stay is 8.42 days, requiring intubation in 12.2% of cases. All patients were treated with the Hydroxychloroquine, Azithromycin, vitamin C, zinc and corticosteroid protocol, 14.6% had undernutrition and 65.9% had a risk of undernutrition. The average BMI was 25.34 kg/m 2 (17-42), 61% had experienced weight loss, which was greater than 8 kg in 26.1% of cases, 12.2% of patients were not autonomous, 12.2% had moderate depression, 2.4% severe depression, 14.6% mild to moderate anxiety, 12.2% severe anxiety and 29.3% suffered acute post-traumatic stress disorder., Conclusion: Patients with COVID-19 are, in addition to the complications from coronavirus infection, vulnerable to undernutrition, psychological and motor complications. Additional care before discharge is essential for better integration of patients into their families., (© 2021 John Wiley & Sons Ltd.) more...

Objectives: Real-time relevant information helps guide the healthcare decision-making process in daily clinical practice as well as the management and optimization of healthcare processes. However, proprietary business intelligence suite solutions supporting the production of decision-making information requires investment that is out of reach of small and mediumsized healthcare facilities or those with limited resources, particularly in developing countries. This paper describes our experience in designing and implementing a real-time healthcare monitoring system solution to manage healthcare emergency units., Methods: Through the use of free Business Intelligence tools and Python data science language we designed a real-time monitoring system, which was implemented to explore the Electronic Medical Records system of a university mental health emergency unit and render an electronic dashboard to support health professional daily practice., Results: Three main dashboards were created to monitor patient waiting time, to access the clinical notes summary for the next waiting patient, and to obtain insights into activity during the last 24 hours., Conclusions: The designed system could serve as a monitoring support model using free and user-friendly data science tools, which are good alternatives to proprietary business intelligence solutions and drastically reduce cost. Still, the key to success in decision-making systems is based on investment in human resources, business intelligence skills training, the organizational aspect of the decision-making process, and data production quality insurance. more...

Background: For ICD-11, the WHO emphasized the clinical utility of communication and the need to involve service users and carers in the revision process., Aims: The objective was to assess whether medical vocabulary was accessible, which kinds of feelings it activated, whether and how users and carers would like to rephrase terms, and whether they used diagnosis to talk about mental health experiences., Method: An innovative protocol focused on two diagnoses (depressive episode and schizophrenia) was implemented in 15 different countries. The same issues were discussed with users and carers: understanding, feelings, rephrasing, and communication., Results: Most participants reported understanding the diagnoses, but associated them with negative feelings. While the negativity of "depressive episode" mostly came from the concept itself, that of "schizophrenia" was largely based on its social impact and stigmatization associated with "mental illness". When rephrasing "depressive episode", a majority kept the root "depress*", and suppressed the temporal dimension or renamed it. Almost no one suggested a reformulation based on "schizophrenia". Finally, when communicating, no one used the phrase "depressive episode". Some participants used words based on "depress", but no one mentioned "episode". Very few used "schizophrenia"., Conclusion: Data revealed a gap between concepts and emotional and cognitive experiences. Both professional and experiential language and knowledge have to be considered as complementary. Consequently, the ICD should be co-constructed by professionals, service users, and carers. It should take the emotional component of language, and the diversity of linguistic and cultural contexts, into account. more...

Objectives: Monitoring healthcare activities is the first step for health stakeholders and health professionals to improve the quality and performance of healthcare services. However, monitoring remains a challenge for healthcare facilities, especially in developing countries. Fortunately, advances in business analytics address this need. This paper aims to describe the experience of a low-income healthcare facility in a developing country in using business analytics descriptive techniques and to discuss business analytics implementation challenges and opportunities in such an environment., Methods: Business analytics descriptive techniques were applied on 3 years' electronic medical records of outpatient consultation of the University Psychiatric Centre (CPU) of Casablanca. Statistical analysis was conducted to compare results over years., Results: Over the 3 monitored years, the monthly number of computerized physician order entries increased significantly ( p < 0.001). Physicians improved their personal recording over years. Schizophrenia as well as depressive and bipolar disorders were noted at the top of outpatient mental disorders. Antipsychotics are the most prescribed drugs, and a significant annual decrease in outpatient care wait time was noted ( p < 0.001)., Conclusions: Business analytics allowed CPU to monitor mental healthcare outpatient activity and to adopt its business processes according to outcomes. However, challenges mainly in the organizational dimension of the decision-making process and the definition of strategic key metrics, data structuration, and the quality of data entry had to be considered for the optimal use of business analytics., Competing Interests: Conflict of Interest No potential conflict of interest relevant to this article was reported., (© 2020 The Korean Society of Medical Informatics.) more...

Targeted photopolymerization is the basis for multiple diagnostic and cell encapsulation technologies. While eosin is used in conjunction with tertiary amines as a water-soluble photoinitiation system, eosin is not widely sold as a conjugate with antibodies and other targeting biomolecules. Here we evaluate the utility of fluorescein-labeled bioconjugates to photopolymerize targeted coatings on live cells. We show that although fluorescein conjugates absorb approximately 50% less light energy than eosin in matched photopolymerization experiments using a 530 nm LED lamp, appreciable polymer thicknesses can still be formed in cell compatible environments with fluorescein photosensitization. At low photoinitiator density, eosin allows more sensitive initiation of gelation. However at higher functionalization densities, the thickness of fluorescein polymer films begins to rival that of eosin. Commercial fluorescein-conjugated antibodies are also capable of generating conformal, protective coatings on mammalian cells with similar viability and encapsulation efficiency as eosin systems. more...

Introduction: Recently, an important literature data has reported that medical students experience stress more than students in other disciplines. In contrast, there is a significant shortage of the stress impact on the academic performance. The primary purpose of our study was to determine the prevalence of stress among Casablanca Medical students and to investigate if there is an association between stress and academic skills., Methods: A total of 275 participants studying at Casablanca Medical School were included. The study was conducted using a self-administered, anonymous questionnaire, which included four subscales on academic skills perception (Academic competence, Test competence, Time management and Strategic study habits) and a Test Anxiety scale to assess the degree of stress related to exams among medical students., Results: The overall findings showed that 52.7% of respondents were stressed by examinations, and the highest stress prevalence was among the fifth-year medical students. Measures of comparative stress degrees between male and female students did not show any statistical significant differences (p=0.34). Correlation analysis revealed negative association between stress and academic competence (-0.394), test competence (-0.426), time management (-0.240), strategic study (-0.183) respectively (p<0.001)., Conclusion: Medical educators and psychologists have to increase clinical awareness of stress among medical students, by establishing strategies for stress management. more...

Background: The aim of the study was to evaluate the prevalence of suicidal ideations and suicide attempts in a representative sample of the general population of the urban area of Casablanca, Morocco., Methods: The survey was conducted based on face-to-face household interviews. The Mini International Neuropsychiatric Interview (M.I.N.I.) was used to assess axis I diagnoses according to DSM-IV criteria and the M.I.N.I. suicidality module to rate the severity of active suicidality., Results: The 1-month prevalence of suicidal ideation was 6.3%. Seventeen subjects (2.1%) reported at least one suicide attempt during their lifetime. Some variables were positively associated to suicidal ideation: the non-married status, subjects with a history of psychiatric disorders, and subjects without children. At least one mental disorder was present among 88.2% of subjects with suicidal ideation. Major depressive disorder was the most prevalent one (23.5%)., Limitations: The sample was small and the prevalence was not determined longitudinally., Conclusion: Suicidal ideation being relatively frequent in the general population, there is a need to develop programs of prevention of suicide. more...

Depressive symptoms frequently occur during the course of schizophrenia. This study explored the relationships between the schizophrenia symptomatology and three measures of depression. Eighty-one drug-free inpatients with acute schizophrenia were assessed with the positive and negative syndrome scale (PANSS), the Calgary depression scale for schizophrenia (CDSS), and the Hamilton rating scale for depression (HAM-D). The depressive subscale of PANSS (PANSS-D) was also considered as a third scale for measuring depression. A principal component analysis (PCA) of PANSS items identified five clinical dimensions of schizophrenia called 'negative', 'positive', 'anxio-depressive', 'excitement', and 'disorganisation and others'. Our anxio-depressive dimension (PANSS-ad) was strictly identical with the PANSS-D. Scores on CDSS and HAM-D were highly inter-correlated and highly correlated with the PANSS-ad. Furthermore, while scores on CDSS were correlated only with this dimension, scores at HAM-D were also positively correlated with the negative dimension and negatively correlated with the excitement dimension. In conclusion, our results suggest that PANSS evaluation itself may be sufficient to give a correct approximation of the depression in patients with schizophrenia. However, depression scales are of course needed to assess specifically depressive symptoms in patients with schizophrenia; hence, the CDSS could be a more specific instrument than HAM-D. more...