Major depressive disorder: Validated treatments and future challenges.

Depression is a prevalent psychiatric disorder that often leads to poor quality of life and impaired functioning. Treatment during the acute phase of a major depressive episode aims to help the patient reach a remission state and eventually return to their baseline level of functioning. Pharmacotherapy, especially selective serotonin reuptake inhibitors antidepressants, remains the most frequent option for treating depression during the acute phase, while other promising pharmacological options are still competing for the attention of practitioners. Depression-focused psychotherapy is the second most common option for helping patients overcome the acute phase, maintain remission, and prevent relapses. Electroconvulsive therapy is the most effective somatic therapy for depression in some specific situations; meanwhile, other methods have limits, and their specific indications are still being studied. Combining medications, psychotherapy, and somatic therapies remains the most effective way to manage resistant forms of depression.

Psychiatric side effects of chloroquine in COVID-19 patients: two case reports.

Chloroquine and hydroxy chloroquine are widely use in Africa and all over the world as anti-malarial drugs but also in the treatment of chronic inflammatory diseases. Since the outbreak of COVID-19 pandemic, Morocco have included this medication in the COVID-19 treatment guidelines in association with azithromycine. Besides dermatologic problems, ocular impairments and gastro-intestinal effects, quinolines may also cause rarely described psychiatric adverse effects. To our knowledge, there has been no reports of psychiatric side effects of chloroquine or hydroxy chloroquine in the actual context of COVID-19 pandemic. Here, we present the description of two COVID-19 patients who showed psychiatric side effects after chloroquine treatment. One patient expressed psychotic symptoms and the other one experienced acute and intense anxiety. In both cases, and according to Naranjo score, the association between chloroquine and psychiatric side effects was probable.

Lithium-Associated Hypercalcemia Presenting with Neuropsychiatric Manifestations in a Patient with Bipolar Disorder.

One of the overlooked adverse effects of lithium treatment is neuropsychiatric manifestations induced by hypercalcemia (LAH). Here, we present the case of a patient, with bipolar disorder under lithium, who presented with neuropsychiatric symptoms that revealed hyperparathyroidism-induced hypercalcemia. This case illustrates the importance of monitoring parathyroid function and calcium levels in patients under lithium, especially in premenopaused women. LAH may mimic symptoms of manic episodes and should be sought in the case of brutal onset of confusion, anxiety, and/or hallucinations in the course of a bipolar disorder.

[Frequency of physical symptoms in anxiety-depressive disorders: cross-sectional study in a population of 202 psychiatric consultants]. / La fréquence des symptômes physiques dans les troubles anxio-dépressifs: étude transversale chez une population de 202 consultants psychiatriques.

INTRODUCTION: physical symptoms associated with anxiety-depressive disorders have been the subject of several studies for several decades given their frequencies and their consequences. The aim of our study was to specify the frequency of the major physical symptoms of anxiety disorders such as panic disorder (PD), generalized anxiety disorder (GAD), phobic disorder (PhD) and depressive disorder (major depressive episode (MDD) in the framework of a depressive disorder). METHODS: we conducted a cross-sectional descriptive study on a sample of 202 consultants in a department of psychiatry. RESULTS: the average age of patients was 42 years (19-70 years), with a slight female predominance (118; 58%). Anxiety-depressive disorders included MDD (113;56%), PD (61;30.2%), GAD (55; 27.2%) and PhD (30;14.9%). Patients with 2 to 5 and more than 5 symptoms accounted for 15.9% and 39.6% respectively (depressive disorders), and 9.5% and 62.9% (anxiety disorders). The most reported symptoms were cardiopulmonary symptoms (75%), general symptoms (73.8%) and neurological symptoms (65.8%). CONCLUSION: physical symptoms associated with anxiety-depressive disorders are variable and often occur together. They can affect prognosis, making these psychiatric disorders difficult to treat. Early screening, paying particular attention to these physical symptoms, helps prevent these complications.

A case report of Lhermitte-Duclos disease revealed by psychiatric disturbances.

BACKGROUND: Lhermitte-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 PRESENTATION: We present here a rare case of a woman who developed depressive symptoms that inaugurated the clinical presentation of LDD. CONCLUSION: Psychiatric 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.

Suicidal ideations, plans and attempts in primary care: cross-sectional study of consultants at primary health care system in Morocco.

INTRODUCTION: The aim of the study is to estimate the prevalence of suicidal ideation among Moroccan consultants in primary health care system. METHODS: We conducted a cross sectional survey in three health care centers in two cities of Morocco to estimate the prevalence of suicidal ideation, plan and suicide attempts among 396 consultants in the primary health care system, using the Mini International neuropsychiatric interview. Patients were 18 years and older, without known psychiatric or chronic somatic disease. Statistical analysis was performed by the SPSS 13.0 software. RESULTS: The prevalence of suicidal ideation was 5.3%, and 2.7% of the patients planned their suicide and 1.2% tried to commit suicide. The multivariate analysis did not demonstrate significant association. CONCLUSION: Suicidal ideation, plan and suicide attempts are prevalent in primary health care patients, but they are still under diagnosed. An adequate training of physicians and the establishment of education programs is essential to reduce the rate of suicide.