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Objective: To assess the prevalence of religious obsessions in a general psychiatry setting, review sociodemographic and clinical characteristics of patients with religious obsessions, and explore the relation between these obsessions and religiosity. Method: In a general psychiatry setting (n = 1500), we have studied patients with an obsessive-compulsive disorder (OCD), and then in this sample, we have identified those who also had religious obsessions. Results: OCD was found in 9.6% (n 144) of patients. Religious obsessions are the most common and were found in 31.3% (n = 45) of patients in this group. Forty-five subjects (n.= 45) with religious obsessions were compared with 99 subjects (n = 99) with other types of obsessions. The total number of obsessions is significantly higher in patients with religious obsessions. Patients with religious obsessions have a significantly higher score at the religiosity scale. Conclusion: These results suggest that religious obsessions are common in patients with OCD, and that they are associated with religiosity. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objectives: First, to explore whether in Morocco, a non-Western country, family members of patients with schizophrenia suffer from stigma and, if they do, which areas of their lives are most affected; and second, to explore family members' knowledge about the illness and their attitudes toward the patients.Methods: The study was conducted among 100 family members accompanying patients with schizophrenia. We used a heteroquestionnaire that inquired about family members' and patients' sociodemographic data, family members' knowledge of the patients' illness, their attitudes and behaviours toward the patient, and their perception of stigma.Results: Family members' mean age was 47.44 years, SD 12.83; 69% were women; 38% had no education; and 77% had no professional activity. Most families (76%) reported having no knowledge about the illness. However, the illness was considered to be incurable (39%), severe (37%), chronic (80%), and handicapping (48%) and was believed to be caused by drug use (25%), stressing life events (such as conflict or bereavement; 46%), sorcery (25%), organic disturbance (30%), or heredity (23%). We found that most of the families suffer from stigma and discrimination. A total of 86.7% reported they have hard lives because of the illness, and 72% reported psychological suffering caused by sleep and relationship disturbances and a poor quality of life.Conclusions: In this study, we found that Moroccan families of patients with schizophrenia suffer from stigma. We found the same results in European, In North American, and in some Arab and Islam countries. Despite the belief that traditional societies are more supportive of the weak and the sick, stigma is a major burden in addition to that of the illness. [ABSTRACT FROM AUTHOR]

Provides information on the World Psychiatric Association's (WPA) Global Programme against Stigma and Discrimination Because of Schizophrenia, a programme established in 1996 to help diminish the stigma related to mental illness. Effects of stigma attached to mental disorders on mentally ill people; Reason behind the increase in the intolerance to mental abnormality; Characteristics of the WPA programme that distinguish it from other previously developed programmes.

Background A national epidemiologic survey was conducted in Morocco in 2003-2004 in order to assess the prevalence of mental disorders in a representative sample of the general population. Methods and subjects About 5,600 persons accepted to be interviewed. The instrument used was the M.I.N.I. in its colloquial Moroccan Arabic, which was validated in a previous study. Results The point prevalence of mental disorders was as follows: depressive disorders: 26.5%; suicidal ideation: 16.6%; bipolar disorder: 3.2%; Panic disorder: 6.6%; Social phobia: 6.3%; OCD: 6.6%; PTSD: 2.1%; alcohol dependence: 1.4%; substance abuse: 3.0%; GAD: 9.3%. All in all, about 48.9% of the sample showed one or another mental disorder. Comparisons will be shown with the same instruments in some European and some African countries. [ABSTRACT FROM AUTHOR]

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]

Objective: To assess the prevalence of religious obsessions in a general psychiatry setting, review sociodemographic and clinical characteristics of patients with religious obsessions, and explore the relation between these obsessions and religiosity.Method: In a general psychiatry setting (n = 1500), we have studied patients with an obsessive–compulsive disorder (OCD), and then in this sample, we have identified those who also had religious obsessions.Results: OCD was found in 9.6% (n = 144) of patients. Religious obsessions are the most common and were found in 31.3% (n = 45) of patients in this group. Forty-five subjects (n = 45) with religious obsessions were compared with 99 subjects (n = 99) with other types of obsessions. The total number of obsessions is significantly higher in patients with religious obsessions. Patients with religious obsessions have a significantly higher score at the religiosity scale.Conclusion: These results suggest that religious obsessions are common in patients with OCD, and that they are associated with religiosity. [ABSTRACT FROM AUTHOR]

Objective: We examine the procedural validity of a standardized instrument for the diagnosis of psychotic disorders in Morocco.Method: Twenty-nine patients from Casablanca, Morocco, with a psychotic or mood disorder were examined using the Comprehensive Assessment of Symptoms and History (CASH) an adapted version using cultural formulation to make the instrument more culturally sensitive (CASH-CS). Chance corrected agreement was calculated between diagnoses based on these two versions of CASH and independent clinical diagnoses according to local psychiatrists.Results: Agreement for traditional CASH versus clinical diagnosis and for CASH versus CASH-CS was low (kappa = -0.19; SD 0.16 and kappa = 0.21; SD 0.16, respectively). De CASH-CS, showed good agreement with clinical diagnosis (kappa = 0.79; SD 0.11).Conclusion: Standardized instruments for the assessment of psychosis such as the CASH may be liable to cultural misinterpretations. This may be relevant to the interpretation of the high incidence rates of schizophrenia among immigrants.Significant Outcomes: Agreement between a culturally naïve version of a standardized diagnostic instrument for the assessment of psychosis and clinical diagnosis by Moroccan psychiatrists is poor. Adding additional probes and decision rules based on cultural formulation improves agreement with clinical diagnosis significantly.Limitations: The study was conducted in a small sample. Both versions of CASH were administered by the same interviewer in a single interview session. [ABSTRACT FROM AUTHOR]

We examine the procedural validity of a standardized instrument for the diagnosis of psychotic disorders in Morocco. Twenty-nine patients from Casablanca, Morocco, with a psychotic or mood disorder were examined using the Comprehensive Assessment of Symptoms and History (CASH) an adapted version using cultural formulation to make the instrument more culturally sensitive (CASH-CS). Chance corrected agreement was calculated between diagnoses based on these two versions of CASH and independent clinical diagnoses according to local psychiatrists. Agreement for traditional CASH versus clinical diagnosis and for CASH versus CASH-CS was low (kappa = −0.19; SD 0.16 and kappa = 0.21; SD 0.16, respectively). De CASH-CS, showed good agreement with clinical diagnosis (kappa = 0.79; SD 0.11). Standardized instruments for the assessment of psychosis such as the CASH may be liable to cultural misinterpretations. This may be relevant to the interpretation of the high incidence rates of schizophrenia among immigrants. Agreement between a culturally naïve version of a standardized diagnostic instrument for the assessment of psychosis and clinical diagnosis by Moroccan psychiatrists is poor. Adding additional probes and decision rules based on cultural formulation improves agreement with clinical diagnosis significantly. The study was conducted in a small sample. Both versions of CASH were administered by the same interviewer in a single interview session. [ABSTRACT FROM AUTHOR]

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]

Premenstrual syndrome (PMS) encompasses a variety of symptoms appearing during the luteal phase of the menstrual cycle. Although PMS is widely recognized, the etiology remains unclear and it lacks definitive, universally accepted diagnostic criteria. To address these issues an international multidisciplinary group of experts evaluated the current definitions and diagnostic criteria of PMS and premenstrual dysphoric disorder (PMDD). Following extensive correspondence, a consensus meeting was held with the aim of producing updated diagnostic criteria for PMS and guidelines for clinical and research applications. This report presents the conclusions and recommendations of the group. It is hoped that the criteria proposed by the group will become widely accepted and eventually be incorporated into the next edition of the World Health Organization's International Classification of Diseases (ICD-11). It is also hoped that the proposed guidelines for quantification of criteria will be used by clinicians and investigators to facilitate diagnostic uniformity in the field as well as adequate treatment modalities when warranted. [ABSTRACT FROM AUTHOR]

Objective: To evaluate quality of life (QOL) among treated and never‐treated schizophrenic patients. Method: QOL ratings were obtained for (a) 112 Moroccan participants with schizophrenia who had never received neuroleptic medications, (b) matched samples of chronically‐medicated schizophrenic patients in Morocco and the United States and (c) matched community controls in both countries. Results: QOL ratings were generally higher for US groups, although Moroccan controls obtained higher ratings than US controls for some domains. QOL ratings were higher for controls compared to patients within each country, although US patients' scores were similar to controls on some dimensions. We found no differences between treated and untreated Moroccan patients for any QOL domain, although relationships among predictors were different. Conclusion: Within the context of Moroccan culture, benefits of medications alone are not evident in QOL scores. QOL appears to be a complex construct influenced by different factors within each of the groups studied. [ABSTRACT FROM AUTHOR]