[Psychiatric disorders and associated factors in patients with epilepsy in Fez, Morocco]. / Troubles psychiatriques et facteurs associés chez une population de patients épileptiques à Fès, Maroc.

BACKGROUND: The prevalence of psychiatric disorders in epileptic patients remains unclear. OBJECTIVE: This study was conducted in order to determine the prevalence and nature of the psychiatric disorders and the associated factors in patients with idiopathic epilepsy. METHODS: A cross-sectional study was conducted over a period of eighteen months in the psychiatric unit of the University Hospital Hassan II of Fez (Morocco). A questionnaire was completed by the included patients, which specified: the socio-demographic data, personal and family history, and the clinical features of epilepsy and its management. Psychiatric disorders were identified by the Mini International Neuropsychiatric Interview test (MINI). The severity of the depression and anxiety symptoms was investigated using the Beck Depression Inventory (BDI) and the Hamilton Rating Scale. RESULTS: Eighty-nine patients met the inclusion criteria. The average age of patients was 29.7±10.8years. Mood disorders were the leading psychiatric comorbidity: 32.6% among which 25.8% of major depressive episodes, 15.7% of dysthymia and 2.2% of hypomanic episodes. Anxiety disorders came second: 28.1% (among which 19.1% panic disorder, 13.5% agoraphobia, 12.4% generalized anxiety disorder, 10.1% social phobia and 4.5% post-traumatic stress disorder). Female gender, unemployment and poor compliance to antiepileptic drugs are all risk factors for the occurrence of psychiatric disorders in this population.

Effect of physical training on mitochondrial function in skeletal muscle of normal and diabetic rats.

The study was designed to assess the impact of physical training on the oxidative phosphorylation rate (OPR) in mitochondria isolated from two different skeletal muscles of rats with or without chronic diabetes mellitus. Diabetes was induced by an intravenous injection of streptozotocin (50 mg/kg), and only animals with a blood glucose level between 14 and 22 mmol/L 1 week later were kept in the protocol. Exercise training was performed on a treadmill with a progressive 10-week program. Rats were killed by decapitation at the end of the training program, and mitochondria were isolated from the gastrocnemius and the red vastus lateralis muscles. When the data were expressed as per milligrams of protein, OPR was significantly depressed by diabetes mellitus in the mitochondria from each muscle; a similar negative impact also appeared to be produced by physical training in mitochondria isolated from the red vastus lateralis muscle. However, due to changes in mitochondrial protein yield between groups, the capacity to oxidize pyruvate and malate was also calculated per gram of muscle. Adenosine triphosphate (ATP) production rate appeared to be unaffected by diabetes but significantly increased by training in both muscles of diabetic and nondiabetic rats. This effect of training was not associated with any improvement in plasma glucose or insulin levels in diabetic animals. However, the large increase in plasma levels of beta-hydroxybutyric acid in sedentary diabetic rats was partly reversed by training (1,079 +/- 472 v 3,424 +/- 618 micromol, P < .001). These results suggest that the training-induced increase in the capacity of skeletal muscles to oxidize substrates and generate energy may also contribute to reduce the elevated plasma beta-hydroxybutyric acid levels observed in a state of insulin deficiency. This may have clinical relevance, since ketoacidosis remains a life-threatening event in insulin-dependent diabetic subjects.