IntroductionCushing’s syndrome is a relatively rare condition that results from chronic hypercortisolism. This syndrome is characterized by the presence of various psychiatric manifestations that can accompany it at all its stages of evolution. They can either inaugurate the clinical picture, or appear during the course of the disease, as they can persist even after the resolution of the syndrome. of Cushing. Through a clinical vignette, we report a case of Cushing’s syndrome in a 52-year-old patient who presented with a picture of melancholic depression as part of a bipolar disorder and who had preceded the discovery of Cushing’s disease.Objectivesestablish the relationship between Cushing’s syndrome and bipolar disorder and identify the main pillars of care.MethodsIt was proposed to present the clinical case of a 52-year-old patient in whom psychiatric manifestations of the psychotic and thymic types preceded the discovery of Cushing’s disease, to recall the main psychiatric symptoms that can be encountered during such endocrine disorders and their possible entanglement with psychiatric pathologies.ResultsMrs. F. is 52 years old. married and mother of 3 children, without social security coverage for medullary carcinoma of the thyroid, having benefited from thyroidectomy with radiotherapy, admitted for treatment of paraneoplastic Cushing’s syndrome. The beginning of his troubles goes back to 6 months before his consultation with psychiatry. The initial symptoms were typical of a progressive weight gain noticed by the entourage. There was the installation of thymic symptoms such as an elation of mood, self-esteem, multiple projects. One month before admission to the internal medicine department, the patient presented with a depressed mood, anhedonia , a disgust for life, and dark thoughts. She had stopped all drug treatment.Cushing’s disease is the most common cause of endogenous hypercortisolism (>85%). Corticotropic micro-adenomas , are the most frequently observed, i.e., in 90% of cases, and are sometimes not visible on magnetic resonance imaging . Its first-line treatment is neurosurgical with trans-sphenoidal excision. In its second intention, it uses drugs whose targets are pituitary or adrenal, as well as radiotherapy.Conclusionswe present the case of a patient with a picture of bipolar mood disorder and Cushing’s disease. Thymic and psychotic psychiatric symptoms preceded the discovery of endocrine disease whose symptoms were not apparent at first. The hypotheses of comorbidity or rather of the inauguration of the endocrine disease by a psychiatric picture, in particular bipolar mood disorder, remain advanced and the limits betweenDisclosure of InterestNone Declared

IntroductionTherapeutic non-adherence is a problem frequently encountered in patients suffering from psychotic disorders. It has consequences on the quality of life and on the prognosis of the evolution of the disease. It is essential to understand the causes in order to best support the patient towards adherence to care.ObjectivesThe objective of the study is to evaluate the therapeutic observance of patients hospitalized in the women’s department of the psychiatric hospital and to collect the reasons for therapeutic non-observance, as well as to identify the desired themes for the implementation group therapeutic education workshops.MethodsIt is a monocentric and prospective study, carried out in the women’s department through individual interviews on day 7 +/- 2 of the admission of patients to the psychiatric hospital of Tangier. The inclusion criteria are:-the patient’s consent,-the autonomous taking of a treatment before admission,-sufficient communication skillsThe psychometric tool used during this study is the MARS scale (Medication Adherence Report Scale) which allows the patient to assess his compliance, by answering 10 questions, assigning himself a score between 0 and 10 with a good compliance from 8/10. The discussion following the questionnaire makes it possible to identify the reason(s) for non-compliance and the themes to be addressed to improve compliance.ResultsOur first initial results were calculated from 60 patients admitted to hospital. Among them, 35 met the criteria for inclusion in the study. The interview takes place within an average of 8.0 ± 2.3 days. The average age is 40 ± 15 years. Patients present with schizophrenia in 80% of cases, bipolarity (8%) or borderline personality disorder (3%). Nine percent of patients have no diagnosis. Patients take an average of 2.5 drugs [1; 5] before hospitalization. The average MARS score is 5.6 ± 2.6. The reasons for non-adherence identified by patients are:-The presence of side effects,-Lack of means-Feeling of healing-The weariness of a long treatment-Inefficiency,-fear of interactions in case of toxic consumption-five patients declared observing and did not identify any reason for non-complianceConclusionsOur study has made it possible to better understand the difficulties and support needs of patients to improve their adherence to care. As a follow-up to this work, a multidisciplinary discussion will allow the setting up of group therapeutic education workshops around the identified themes.Disclosure of InterestNone Declared

Introduction:Cannabis is the drug which use is the mostwidespread in the world, and particularly among young people. Medical students are not the exception. Exposure to a variety of factors, including stress, burnout, and relatively easy access to medications make them vulnerable to substance use. Objective: to study the prevalence of cannabis use among medical students and to assess its repercussions in terms of anxiety and depression. Methods: It is a descriptive and analytical cross-sectional study of medical students of different medical schools in Morocco. Data collection was through an anonymous online self-administered survey. The measuring instruments used were surveys evaluating the main socio-demographic data, the CASTfor identifying problematic cannabis use, and the HAD scale which evaluates anxiety and depression in the group. The data is grouped and analysed by statistical software. Results: In this sample of 183 students (44.8% boys, 55.2% girls), the average age was 23.31 years. 21% had a psychiatric history. 32.2% consumed cannabis, half occasionally versus a third on a daily basis. Men had higher consumption rates than women with a significant difference. For the CAST results, 40% of cannabis users had a high risk of addiction. Anxiety score averaged 7.66 cannabis users and 5.52 for non-users, depression score averaged 5.88 users and 4.43 for non-users with significantly higher averages among users. Conclusion:Medicalstudentsseemparticularlyaffected by addictions. They must benefitfrom an assistance in order to improvetheirhealth, sothey can exercisetheirrole and be able to provide care to patients.

Introduction: The prevalence of heroin use in Morocco was 0.02%. These figures were higher in the northern region of Morocco. The personality disorder represented a difficulty in the management of the heroin addicted patient. The aim of this study was to show that personality disorders were often comorbid with heroin addiction and to specify the predominant pathological personalities in the Moroccan population. Material and methods:A descriptive cross-sectional study in a population of 171 subjects.Collection of sociodemographic and clinical data by form.Scale:Personality Diagnostic Questionnaire (PDQ - 4+)Statistical analysis: Excel 2016, SPSS 2021: Student test, ANOVA and CHI-2 Results:Sample of 171 patients with 97.7% of male patients and average age of 43,59.Half of the population (48.5%) had only primary education80.7% never received psychiatric care.The average number of incarcerations in our population was 3,96The predominant personality disorders were borderline and antisocial personality disorder respectively.Statistically significant relationship between borderline personality disorder and psychiatric history and the number of hospitalizations in psychiatric units.Statistically significant relationship between the number of incarcerations and antisocial personality disorder. Conclusion: Heroin addicts in Morocco suffered from social instability, strong cannabis dependence, delinquency and frequent judicial recidivism. The most frequent personality disorders were borderline and antisocial. However, the causal link between the personality disorder and the addiction remained to be defined.

Background: Self-esteem is of great importance for positive and confident social behavior. Assertiveness is the component of self-esteem that allow that confident and forceful behavior while maintaining respect for others. Our study sought to evaluate the impact of an assertiveness training program on medical school students skills in communication and assertiveness. Method:123 first-year students (sex ratio (boys/girls):0,52) submitted to practical workshop training sessions during one month, evaluated at the beginning (T0) and the end (T1) of the training program by adapted auto-questionnaires measuring the feeling of self-efficacy when facing social situations, the assertiveness, self-esteem and also esteem in own communication capacity. Results: A significant improvement was seen in the mean scores of communications [58.51 to 64.62 i.e. + 6.11 (CI95% [4.66 7.56]). but also, in assertiveness [73.45 to 86.4 +12.95 (CI95% [10.46 15.43], for both sexes. Conclusion. Assertiveness programs have a positive impact in students self-esteem, assertiveness and communication skills. They must more seriously be considered as an important in schooling.