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Résumé Contexte et objectif La prévalence des troubles mentaux en population générale marocaine est de plus de 40 %. Le secteur de la santé mentale au Maroc souffre d’un déficit important en moyens humains et matériels. Il s’agit dans cette étude d’évaluer les spécificités épidémiologiques, cliniques et culturelles des patients hospitalisés au centre psychiatrique universitaire de Casablanca pour pouvoir adapter et optimiser l’offre de soin. Patients et méthode C’est une étude descriptive et analytique, menée au sein du centre psychiatrique universitaire de Casablanca sur 4033 dossiers de patients hospitalisés entre janvier 2001 et janvier 2011. Résultats Profil sociodémographique : l’âge moyen des patients est de 31,5 ans. Soixante-dix-sept pour cent sont de sexe masculin et 74 % sont célibataires. Les patients ont été scolarisés à 92 %, et 83,7 % d’entre eux sont au chômage. Usage de drogues : 84 % des hommes et 19 % des femmes consomment des toxiques, toutes substances confondues, et 68 % des hommes consomment régulièrement du cannabis. Diagnostic Les diagnostics retenus sont significativement différents selon le genre. Ainsi, nous avons retrouvé chez les hommes 64 % de troubles schizophréniques, 22 % de troubles bipolaires et 8 % de dépressions. Chez les femmes, le trouble bipolaire et la dépression sont les diagnostics les plus fréquents, estimés respectivement à 35 % et 30 %, le taux de troubles schizophréniques est de 27 %. Antécédent judiciaire Le taux d’incarcération antérieur à l’hospitalisation s’élève à 17 % des hommes et 4 % des femmes. Les délits les plus fréquents sont les coups et blessures suivis des vols. Treize homicides et 16 viols ont été répertoriés. Conclusion Le centre psychiatrique universitaire de Casablanca ne gère que les cas extrêmes, souvent socialement vulnérables et dont l’abus de substances est une comorbidité fréquente. Context and objectives The prevalence of mental disorders in the Moroccan general population is over 40%. The sector of the mental health in Morocco suffers from an important deficit in human and material resources. Despite all the efforts, Morocco has currently one psychiatrist per 100,000 people and a metropolis like Casablanca with 5 million inhabitants who has only 250 psychiatric beds. The main objective of this study was to find out the sociodemographic, clinical, addictive and criminological profiles of the patients hospitalized in the Ibn-Rushd university psychiatric centre of Casablanca, to define their specificities and to compare them to the world data. Methods Our study was carried out on the Ibn-Rushd university psychiatric centre of Casablanca inpatients between January 2001 and January 2011, a period of 10 years. Within the scope of the study, 4033 files of patients were analyzed. The demographic, clinical, addictive and criminological data were studied. The statistical analysis was carried out by the software Epi information version 6.04 (Center for Disease Control and prevention CDC, Atlanta, the USA). P value less than 0.05 was considered statistically significant. Results Sociodemographic data: The mean age of the inpatients was 31.5 years. A total of 77.7% were males. Men had a significantly higher rate of celibacy: 80% of men were unmarried against 54% of women ( P < 0.0001). Ninety-two percent of inpatients were educated but 21% of women were illiterate. Forty-nine percent made secondary studies and 11% went to university. A total of 83.7% of inpatients were unemployed. Drug use: Our study found a great disparity between men and women. Eighty-four percent of men and 19% of women used drugs. Eighty-three percent of men were smokers. Sixty-eight percent used cannabis, 43.3% alcohol and 16.1% psychotropic. Criminal record The rate of incarceration prior to hospitalization was 17% of men and 4% of women. The most common offenses were assaults followed by theft. Thirteen homicides and 16 rapes were reported. Thus, among all patients hospitalized in the Ibn-Rushd university psychiatric centre, 6.8% were incarcerated for assault, 4.4% for robbery, 0.4% for rape and 0.3% for homicide. The average length of incarceration was 14 months. Diagnosis Diagnoses were those mentioned at the admission of patients. The results are significantly different by gender: 64% of men suffered from schizophrenic disorders, 22% from bipolar disorder, and 8% from depression. Bipolar disorder and depression are the most frequent diagnosis in women respectively 35 and 30%, the rate of schizophrenic disorders was 27%. Discussion and conclusion Our study allowed to give the profile of the Ibn-Rushd university psychiatric centre inpatients. The sociodemographic and economic characteristics of our patients reflected the social precarity in which they live. The study highlighted the extreme frequency of drug use (mainly cannabis). Because of the shortage of psychiatric units in Morocco, the Ibn-Rushd university psychiatric centre handled only the most extreme cases which were socially vulnerable with substance abuse as a common comorbidity. So, we can suppose that the other patients use the traditional care system: the “Fqih” and “witchdoctor”. In fact, the dominant social representation of mental illness in Morocco is the magical and supernatural explanation which is rooted in the popular culture. Furthermore, despite the belief that the traditional societies like Morocco are more supportive, stigma is a heavy burden in addition to the disease. Other prospective studies are needed to confirm this trend. The final goal is to develop and adapt the offer of care according to the Moroccan specificities. [ABSTRACT FROM AUTHOR]

Abstract: 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. [Copyright &y& Elsevier]

Abstract: Background: Current classifications of Mental Disorders are centered on Westernized concepts and constructs. “Cross-cultural sensitivity” emphasizes culturally-appropriate translations of symptoms and questions, assuming that concepts and constructs are applicable. Methods: Groups and individual psychiatrists from various cultures from Asia, Latin America, North Africa and Eastern Europe prepared descriptions of main symptoms and complaints of treatment-seeking women in their cultures, which are interpreted by clinicians as a manifestation of a clinically-relevant dysphoric disorder. They also transliterated the expressions of DSM IV criteria of main dysphoric disorders in their cultures. Results: In many non-western cultures the symptoms and constructs that are interpreted and treated as dysphoric disorders are mostly somatic and are different from the Western-centered DSM or ICD systems. In many cases the DSM and ICD criteria of depression and anxieties are not even acknowledged by patients. Limitations: The descriptive approach reported here is a preliminary step which involved local but Westernized clinicians-investigators following a biomedical thinking. It should be followed by a more systematic–comprehensive surveys in each culture. Conclusions: Westernized concepts and constructs of mental order and disorders are not necessarily universally applicable. Culturally-sensitive phenomena, treatments and treatment responses may be diversified. Attempts at their cross-cultural harmonization should take into consideration complex interactional multi-dimensional processes. [Copyright &y& Elsevier]