BackgroundData on psychoactive substance (PAS) consumption among adolescents in the North Center of Morocco are not at all available. Therefore, the current study aimed at investigating the prevalence and the determinants of psychoactive substances use among middle and high school students in this region.MethodsA cross-sectional study was conducted from April 2012 to November 2013 in public middle and high schools in the North Central Region of Morocco. An anonymous self-administered questionnaire was used to assess psychoactive substances use among a representative sample of school students from the 7th to the 12th grade, aged 11–23 years, selected by stratified cluster random sampling. Factors associated with psychoactive substance use were identified using multivariate stepwise logistic regression analyses.ResultsA total of 3020 school students completed the questionnaires, 53.0 % of which were males. The overall lifetime smoking prevalence was 16.1 %. The lifetime, annual and past month rates of any psychoactive substance use among the study subjects were 9.3, 7.5, and 6.3 % respectively. Cannabis recorded the highest lifetime prevalence of 8.1 %, followed by alcohol 4.3 %, inhalants 1.7 %, psychotropic substances without medical prescription 1.0, cocaine 0.7, heroine 0.3, and amphetamine with only 0.2 %. Psychoactive substance use was associated with males more than females. The risk factors identified by multivariate stepwise logistic regression analyses were being male, studying in secondary school level, smoking tobacco, living with a family member who uses tobacco, and feeling insecure within the family.ConclusionsThe prevalence among all school students reported by the current study was comparable to the national prevalence. Efforts to initiate psychoactive substance prevention programs among school students should be made by designing such programs based on the significant factors associated with psychoactive substance use identified in this study.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3143-5) contains supplementary material, which is available to authorized users.

BackgroundLhermitte–Duclos disease (LDD) is a rare cerebellar lesion characterized by a hamartomatous lesion in the posterior fossa. Mainly diagnosed by MRI, the clinical presentation is usually made of neurological symptoms.Case presentationWe present here a rare case of a woman who developed depressive symptoms that inaugurated the clinical presentation of LDD.ConclusionPsychiatric symptoms may occur in all brain lesions, delaying the diagnosis and causing therapeutic escalation. More attention should be given by practitioners to psychiatric aspects of LDD.

BackgroundSuicidal behavior is a major cause of injury and death worldwide, especially among adolescents and young adults. Few studies have tackled this issue in the Arab world. The present study investigated the prevalence and the risk factors of suicidal behaviors among Moroccan school students.MethodsFrom April 2012 to November 2013, a cross-sectional study was conducted in the North-Centre region of Morocco among students in public secondary schools selected using stratified cluster random sampling. The data were collected via anonymous self-administered questionnaires. The Mini International Neuropsychiatric Interview was used in its Moroccan Colloquial Arabic version to assess suicidality according to the DSM-IV criteria.ResultsA total of 3020 students (53 % boys) aged 11–23 years (average age = 16 ± 2.1 years) were included in the study. The prevalence of suicide ideation, suicide planning and suicide attempts during the last month were 15.7, 6.3, and 6.5 % respectively.Univariate analyses demonstrated that suicidal behaviors followed different epidemiological patterns. According to the multivariate analyses, the risk factors for all suicidal behaviors among Moroccan school students were the female gender, middle school level, urban locations, low family income, parents’ divorce, tobacco consumption and psychoactive substances (alcohol and cannabis) use.ConclusionsThe intervention of preventive programs has become an emergency to overcome the issue of suicidality in Morocco. Further researches on adolescents’ suicidal behaviors are suggested to update temporal data and assess the effectiveness of potential interventions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-015-0680-x) contains supplementary material, which is available to authorized users.

Introduction and aimEating disorders (EDs) are complex, multifactorial diseases linked to biological, developmental, psychological, and sociocultural factors. Medical students are among subjects at high risk of EDs. The aim of the present investigation was to evaluate EDs among 710 Moroccan medical students with a focus on cognition and behavior related to EDs.MethodsSociodemographic, economic, and clinical data were collected. Validated questionnaires, such as the SCOFF (Sick, Control, One Stone, Fat, Food) questionnaire and the Eating Disorder Inventory 2 (EDI2), were administered.ResultsThe male:female ratio was 0.53, mean age was 21±2 years, 11.1% of participants were underweight, 13.4% were overweight, and 1.8% were obese. A middle socioeconomic level was found in 84.9% of cases. The prevalence of EDs in students was 32.8% (37.6% among females and 23.7% among males) and that of weight-control behaviors 18.5%. Increased body-mass index values were significantly associated with dieting (P<0.001), fasting (P=0.044), and the use of appetite suppressants (P=0.037).ConclusionIt appears that the impact of EDs is high, affecting a third of medical students, with significant use of harmful weight-control behaviors. We also found that dimensions of bulimia, perfectionism, body dissatisfaction, and ineffectiveness, parts of the core of EDs, were found in future medical practitioners.

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Background: The global prevalence of diabetes is increasing worldwide. In Morocco, diabetes and depression are major public health problems, requiring improvement in their care. Diabetes and depression are associated with morbidity and early mortality. This association contributes to raising the risk of the complications that occur, while causing higher suffering to patients, as also an increased cost toward healthcare. Aim: This study aims to assess the prevalence of depression in patients with type 2 diabetes (T2D), and identify the main risk factors for depression in this category of diabetic patients. Patients and Methods: Type 2 diabetic patients and older than 18 years of age were recruited. The exclusion criteria included being type 1 diabetic, pregnant woman, hospitalized patients, a history of neurological disorders, such as, stroke, infectious episidodes, and history of psychiatric disorders. The individual patient data was collected through individual and confidential interviews lasting 30 minutes, at the end of the diabetology consultation, by the same diabetologist, trained to use the psychometric scales that were needed. The Moroccan–Arabic version of the Beck diagnostic scale of depression was used. Patients assessed with depressive disorders were reviewed in a specialized psychiatric consultation. The statistical analysis was achieved by using SPSS package (version 17). We retained a threshold P value of 0.05. Settings and Design: A cross-sectional study was conducted that included adults with type 2 diabetes. The depression diagnosis was performed using the Arabic version of the Beck Depression scale. Statistical Analysis: We included 142 patients with type 2 diabetes, with an average age of 56.26 years. The prevalence of depression was 33.1%. The risk factors recognized for depression were, lack of social security, hypertension, and a history of type 2 diabetes of more than five years. Results and Conclusions: In this study, we have focused on the frequent association of ‘Type 2 diabetes and depression’ and the risk of mutual aggravation of both pathologies that might require multidisciplinary healthcare, as well as, improvement in the risk factors of depression through improved access to healthcare, with the extension of social security. The stability of the healthcare personnel involved in the treatment of both chronic diseases, including diabetes and hypertension screening, should also be considered for better management of psychiatric complications.

O UR PATIENT, A 40-year-old woman with bipolar disorder, was admitted to our unit complaining of dizziness and diplopia for the last 2 days. The patient had been undergoing stable carbamazepine (CBZ) treatment (600 mg/day) for 10 years. CBZ levels were regularly measured and they were within therapeutic range (7.3 mg/mL, 16 days before admission). Four days before the patient's admission she was prescribed fluconazole (150 mg/day) for a fungal cervical infection. After 2 days of antimycotic treatment, the patient noted double vision, nausea, vomiting and dizziness, which gradually worsened. Neurological examination during her admission revealed a symmetrical, horizontal, high-frequency, gaze-evoked nystagmus. In the examination of the eye smooth pursuit movements, many saccades were noted. All the other neurological examinations, including tests for ataxia or certain eye muscle palsy, were normal. In addition, full blood tests and a brain computed tomography scan were obtained, without any pathological findings. However a toxic, nearly twofold increase of the plasma CBZ levels was noted (plasma CBZ levels were 18 mg/dL, with a therapeutic range 5-10 mg/dL in our laboratory). A day after fluconazole withdrawal, the patient reported that all her symptoms disappeared and the neurological examination was perfectly normal. CBZ plasma levels returned to normal limits (9 mg/mL) 5 days after the antimycotic treatment cessation. All plasma concentrations of CBZ were measured in a morning blood sample, obtained prior to the drug administration.The aforementioned adverse effects were most likely associated with CBZ-fluconazole co-administration. Some first reports of potential stupor 1 or asymptomatic transient increase of CBZ plasma levels 2 after fluconazole and CBZ co-administration have implied a toxicity of this drug combination. The originality of our report is that the symptoms emerged in a patient treated with CBZ as a mood stabilizer for bipolar disorder, in a much lower dosage (600 mg/day) compared with Ulivelli's case report (1200 mg/day). 3The explanation of the above toxic effects could be the metabolism interaction of the two drugs. CBZ is primarily metabolized by the cytochrome P450 3A4 isoenzyme.4,5 CBZ is involved in pharmacokinetic interactions of clinical significance due to its co-administration with other drugs known to inhibit or induce CYP3A4 or other relative isoforms.4 Fluconazole is excreted by the kidney, but has been noted to inhibit CYP3A4 and P2C9 isoenzymes. However, clinically significant drug interactions may occur only in certain patients, 6 depending on several individual characteristics, such as genetics, health, nutrition, age, and concomitant drug administration.Our observation suggests that the interaction between fluconazole and CBZ requires further investigation and clinical attention. The incidence of fungal infections is high in everyday clinical practice. Thus both neurologists and psychiatrists, who use CBZ for its multiple indications, should be aware of toxic effects that may...

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