Moroccan version of the short Tobacco Craving Questionnaire (MTCQ-12).

INTRODUCTION: Craving is a key clinical dimension in the assessment and management of substance use disorders. It is also a recognized predictor of relapse in addictology. To date, no scale for measuring tobacco craving is available to Moroccan clinicians. This work proposes a cross-cultural validation of the Tobacco Craving Questionnaire (TCQ) in its short version. METHODS: This work consists of the creation of a translated version according to a rigorous methodology and the evaluation of its psychometric properties in a statistical study. RESULTS: The validation study was done on a sample of 130 smokers with a majority of men (95%). It showed a high acceptability and homogeneity with a Cronbach's alpha coefficient of 0.82. The four scale factors showed a high discriminant validity. Finally, the scale showed high reproducibility with an inter-observer stability of 0.95 and 0.94 between tests and retests. CONCLUSION: The Moroccan version of the TCQ-12 scale shows good validity indices for measuring craving in Moroccan smokers and also shows that it measures independently the four clinical dimensions of the scale.

[The determinants of emotional climate in families of patients with schizophrenia: a cross-sectional study of 50 families]. / Les déterminants du climat émotionnel dans les familles de patients avec schizophrénie: étude transversale sur 50 familles.

Introduction: expressed emotion (EE) is a concept which dates back to the sixties and refers to the attitude that relatives have toward a family member with schizophrenia. It comprises three behavioral patterns: criticism, hostility, and emotional overinvolvement. An important body of literature has shown that high expressed emotion (EE) is a factor of relapse in schizophrenia. The purpose of our study was to measure expressed emotion in the families of a Moroccan sample of patients and then to investigate factors associated with high EE. Methods: fifty (50) patients with stable schizophrenia, each with a relative involved in their care, were recruited during outpatients visits. Sociodemographic data were collected and the FAS scale was used by relatives. Data were also collected from the mental representations of relatives about the patient and disease. Statistical analysis was carried out using the SPSS software and was based on the Chi 2 tests as well as T tests for independent samples. Results: forty-eight percent (48%) of relatives had a high EE. High EE was associated with a feeling of shame toward the patient. It was also associated with cannabis addiction. Low EE was associated with the fact that the patient financially took care of his family. Conclusion: the knowledge of the determinants of high EE in our socio-cultural context is essential in order to direct any psycho-educational intervention aimed at reducing EE.

The prevalence and associated factors of depression, anxiety, and PTSD among Moroccan medical doctors in the COVID-19 pandemic: a national study.

COVID-19 pandemic is facing healthcare professionals with unprecedented challenges, which might alter their mental health. We targeted assessing depression, generalized anxiety, and post-traumatic stress disorder (PTSD) of Moroccan medical doctors during the COVID-19 pandemic; this would allow identifying the associated factors. A cross-sectional national study was carried out on 1267 exposed and unexposed public health medical doctors to COVID-19 patients. The study was conducted between May 15 and 15 June 2020. An anonymous self-administered questionnaire was completed online voluntarily and randomly. We used the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder (GAD-7), and the PTSD Checklist for DSM­5 (PCL-5) to assess depression, generalized anxiety, and PTSD, respectively. The respondents' rate was 63.3%. The mean age was 30.97 ± 6.65 years old, and 59.3% (N = 751) were females with a sex ratio M/F of 0.68. The sample included 43.0% (N = 545) of COVID-19 frontline doctors. Among all participants, 31.5% (N = 400) had depression, 29.2% (N = 370) had generalized anxiety, and 21.7% (N = 276) had PTSD. The average scores of the PHQ-9, the GAD-7, and the PCL-5 were 7.79 (± 5.54), 6.12 (±5.72), and 18.58 (±17.62), respectively. The multivariate logistic regression showed that working in primary and secondary hospitals, moderate and high-stress perceptions, a chronic physical illness, and a family history of psychiatric disorder were independently associated factors of depression, generalized anxiety, and PTSD. The females expressed significantly more anxiety. Doctors living in a family consisting of member with chronic disease showed a significantly higher risk of PTSD. The security sense of contamination risk and low threat perception of COVID-19 were significantly protective factors of depression, anxiety, and PTSD. Moroccan medical doctors are in psychological distress. It is essential to preserve medical doctors' mental well-being health for a better fight against the COVID-19 pandemic through effective and targeted health policies.

Are Patients with Schizophrenia Reliably Reporting their Cannabis Use? An African Cross-sectional Study.

BACKGROUND: Most studies of the prevalence of cannabis use among patients with schizophrenia used a self-report as declared by the patient himself. We hypothesize that patients with schizophrenia did not tell the truth and might underreport their use for many reasons to be discussed later. Indeed, the under-report of cannabis use among these patients can affect the effectiveness of their treatment. AIMS: To assess the degree of agreement between the prevalence values obtained from patients' reports and the results of the toxicological tests. METHODS: A cross-sectional study was carried out on 403 patients with schizophrenia. A sociodemographic, psychiatric history and illicit drug use profile was performed for each patient. We assessed the patients with the Positive and Negative Syndrome Scale (PANSS), Calgary Depression score (CDSS), Barratt Impulsiveness Score (BIS-10) and Medication Adherence Rating Scale (MARS). The consumption of cannabis used was confirmed with MINI International Neuropsychiatric Interview (MINI-DSM IV) and using toxicological analysis. RESULTS: Among the 403 patients who consented to give their urine samples, 49.1% (198/403) tested positive for cannabis, and 41.41% (82/198) underreported their use. The sensitivity and specificity of the questionnaire were 0.58 and 0.74. Based on the comparison between sociodemographic and psychiatric history data of patients who self-report and underreport their cannabis use, no significant difference was observed except for the duration of cannabis use and the score on the medication adherence scale. Moreover, it was found that impulsivity, PANSS score, CDSS score, and the type of schizophrenia are not involved in predicting the underreporting of cannabis use. CONCLUSION: The rate of patients who under-report cannabis use is important. Therefore, toxicological analysis is becoming relevant for identifying drug use among schizophrenic patients and in the addictive comorbidity research field.

Burnout among physicians and caregivers in oncology: the Moroccan experience.

Purpose: Caregivers in radiation oncology are exposed to a high risk of burnout which sometimes causes serious consequences for their health, which can in turn affect patient care. In this study, we investigated the prevalence of burnout and its psychological impact on health professionals and determined the factors that predispose to the risk of burnout. Methods and materials: A cross-sectional survey was conducted with descriptive and analytical purposes among the different teams within the oncology and radiotherapy departments in different hospitals (CHU and regional hospitals) in Morocco, through an online self-questionnaire composed of sociodemographic data, professional data, working conditions, an assessment of interfering factors, the Maslach Burnout Inventory (MBI), the Generalised Anxiety Disorder-7 (GAD-7) scale and the Patient Health Questionnaire-9 (PHQ-9) scale. Results: One hundred and eighteen caregivers participated in this evaluation. 62.7% were physicians, 75.4% worked in university hospitals and 53.4% were in radiotherapy departments. Analysis of the three dimensions of the Maslach Burnout Inventory - Human Services Survey (MBI-HSS) score found high scores in the dimensions of emotional exhaustion (81.4%) and depersonalisation (79.7%), and low scores in decreased personal accomplishment (46.6%). The evaluation of the impacts of burnout in the latter found a mean of the Patient Health Questionnaire-9 (PHQ-9) at 12.45 + 7.84 and the mean of the GAD-7 at 9.73 + 5.98. Conclusion: Our results are in line with those found in the literature, hence the need for screening and active prevention of burnout among radiation oncology caregivers.

[Folie à deux, symptoms sharing us a relationship modality: a case report]. / Folie à deux ou le partage de symptômes comme modalité relationnelle: à propos d'un cas.

Shared Psychotic Disorder or Folie à deux is a rare and controversial entity that raises phenomenological, nosographic and psychopathological issues. It questions the nature of dilusion and its occurrence outside the psychotic structure and also the issue of symptoms contagion in psychiatry. We offer a semiological analysis of an intrafamilial case of Folie à deux, a case with the clinical specificity of sharing not only delusional symptoms but also non-delusional psychotic elements. We then dig back in the epidemiological characteristics and common factors to other reported cases in the literature of different cultures. Then we draw a history of the entity and its evolution over the classifications since its first description by Legrand to the DSM 5. From here, we emphasize the insufficiency of a purely descriptive approach and focus on the possible link with other more common clinical situations of mental symptoms transmission between two or more persons. Then, we propose a psychopathological reflection that essentially targets the sharing of the symptom rather than its nature while questioning the function of the delusion in a delusional couple.

[Nosographic considerations on delusional parasitosis based on three clinical observations]. / Considérations nosographiques sur le délire d'infestation parasitaire à travers trois observations cliniques.

Ekbom syndrome or delusional parasitosis is a rare disease characterized by the unwavering conviction of having cutaneous infestation of insects or parasites. This is a monothematic delusion of hallucinatory origin that typically affects older women. We report the case of three patients with delusional parasitosis in different clinical settings. The first patient suffered from isolated delusional parasitosis corresponding to the condition described by Karl Ekbom. The second case suffered from secondary delusional parasitosis, occurring in the setting of leukoencephalopathy (CADASIL). Lastly, the third patient appeared in a state which was evocative of a depressive episode with psychotic symptom integrating delusional parasitosis. These three clinical vignettes perfectly illustrate the trans-nosographic dimension of this syndrome and the difficulties in treating these patients, both in terms of therapeutic alliance and of choice of pharmacological treatment.

Penile self-mutilation preceded by bizarre delusions: two case reports.

INTRODUCTION: Genital self-mutilation is listed as a symptom of borderline personality disorder. The type of injury varies from simple skin laceration to total amputation of the penis and testicles. These injuries are urological and surgical emergencies. CASE PRESENTATION: We report two cases of penile self-mutilation precipitated by erotic and religious bizarre delusions.Our first patient is a 24-year-old Moroccan man who visited our emergency room with a metallic ring at the root of his penis which had caused marked edema of his entire penis.Our second patient is a 26-year-old Moroccan man evaluated in our emergency unit. A clinical examination revealed a wound at the dorsal side of his penis with complete transection of the dorsal vein and imperfect hemostasis.The two patients were treated in our emergency unit after which a favorable clinical course was observed. CONCLUSION: Cases of genital self-mutilation are urological and psychiatric emergencies, therefore it is important that surgical and psychiatric teams collaborate closely while managing cases of genital self-mutilation.