Hemodialysis (HD) has a severe impact on the life of HD patients. The aim of this work was to assess the prevalence of depression and anxiety disorders, suicidal ideation, and the quality of life among HD patients. Associated factors were also studied. A cross-sectional study was carried out among 103 HD patients treated at the HD Center of Al Farabi Hospital of Oujda during a period of six months in 2015. The Mini-International Neuropsychiatric Interview and European Quality of Life-5 Dimensions (EQ-5D) were used for the assessment. Major depressive episode (MDE) was found in 34% of our patients, whereas anxiety disorder was observed in 25.2%. Suicidal ideation was found in 16.5% and 1.9% of our patients planned their suicide. The EQ-5D index was 0.41 ± 0.36 and the EQ-Visual Analog Scale score was 45.73 ± 14. Multivariate analysis showed that MDEs were associated with three factors: marital status, pain, and anxiety disorder. There was also an association between anxiety disorder and age and EQ-Visual Analog Scale score. Suicidal ideation was associated with marital status and anxiety disorders. Together, these results underline the importance of the collaboration between nephrologists and psychiatrists for a better care of HD patients.
Background Neuroleptic malignant syndrome (NMS) is an uncommon and lethal side effect of neuroleptics. The clinical expression of this syndrome is diverse. Even with criteria diagnosis, it is hard to recognize it easily. We report a series of 25 cases of NMS among patients hospitalized in psychiatric service at Oujda for 5 years. We have described the clinical characteristics of NMS in these patients, the treatments received, the management, and the course of this syndrome. Results Most of the patients are hospitalized for psychotic or affective disorders according to the Diagnostic and Statistical Manual of Mental Disorders (DSM V) criteria. 92% of patients received conventional neuroleptic, and half of them were under the injectable form. No patient took long-acting injectable antipsychotics. 36% of patients received neuroleptics for the first time. NMS appeared in the first week after the admission in psychiatric service among 24 patients. The most common clinical and biological signs were muscular rigidity, the elevation of creatine phosphokinase (CPK), and alteration of blood pressure. Other symptoms were found in proportion varied between 24% and 72%. 32% of the patients did not develop complications. One patient developed renal failure. All patients recovered, and no deaths were recorded. Conclusions Early recognition of NMS help to rescue patient. It is necessary to detect this syndrome even in the absence of main signs such as fever.
Objective:To determine the prevalence and the impact of depressive disorders in primary health care and its associated factors.Methodology:It's a cross-sectional study with 351 participants selected from Moroccan primary care facilities, aged above 18 years without chronic somatic or psychiatric disease. The participants answered a questionnaire that included demographic characteristics, the Mini International Neuropsychiatric Interview for major depressive episode (MDE), dysthymic disorder and the Global Assessment of Functioning (GAF). Statistical analysis was performed by the SPSS 13.0 software.Results:The prevalence of depressive disorders in the sample was 13.7%, that of MDE was 9.1%, while dysthymic disorder was 4.3%, the rate of recurrent depressive episodes was 38.2% (6% of participants), and the prevalence of depression over a lifetime was 17.7%. The percentage of depression was higher among women than men (P = 0.01). 6.3% of depressed patients have already attempted to suicide. Analysis of GAF scores showed an average of 76.2 ± 24, a lower score was significantly found among patients with current MDE (P = 0.001), dysthymic subjects (P = 0.001) and those who suffer from recurrent MDE (P = 0.001). Depressive disorders in univariate analysis were associated with: Female gender P = 0.01 odds ratio (OR) 2.1 (1.09–4.3), unemployment P = 0.02 OR 0.4 (0.2–0.9), and childbearing age P = 0.004 OR 3.5 (1.5–8). Adjusted OR has not demonstrated a significant association.Conclusion:The high prevalence of depressive disorders, suicide risk, and the alteration of the quality of life among primary health care patients in Morocco suggest the importance of identifying and treating this population.
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