For the overall sample
According to our study, our socio-demographic results are very similar to global data. Indeed, 82.9% of sick patients are men, 69% in Algeria [4], 68.8% in Israel [5], and 63.8% in France [6]. At the national level, this similarity is not clear 47.2% [3] with 77.7% in Casablanca [7], 46.4% in Kenitra [8], and 37.53% in Tetouan [9]. The high sex ratio in favor of men (4.9) could give the illusion that men are the most affected by psychiatric disorders, something that is not fair if we take into account the social position of women and the traditional customs that mark the Moroccan population in general and the population of our study region in particular. The family hierarchy that made the man first worried about his health state and benefited from medical care. Stigma can also explain these differences, as the image of women in the population is more sensitive than that of men. All these factors can explain the significant difference between the number of men and women who appear before public health services and a psychiatric center.
The similarity of our results with those of the global data is also evident in the age factor. Indeed, the average age of our overall sample, rather young 31 years, is like that found in Casablanca 31.5 years [7]. On an international level, the difference observed in Chile 36.2 years [10] and in Switzerland 44 years can only be relayed to the youth of the Moroccan population [7]. The age group most affected by psychiatric disorders ranges between 20 and 40 years with a peak between 20 and 30 years, a pivotal period in life, in which most social ties are formed, patients would be deprived of experience and interaction with their surroundings, which would cause them real handicaps for social integration. The urbanity rate in the region of our study is expected to be 71.1%, This result is consistent with the result of the national survey [11]. The work of Peen et al. [12] on 20 populations showed the dominance of psychiatric disorders in urban settings. In addition, a study conducted in rural and urban Canada found that urban origin was a risk factor for psychiatric disorders [13]. This study questioned the lack of social support in urban areas as opposed to rural areas where interdependence prevails over individuals; these same factors could be involved in the explanation of the high rate (71.1%) of psychiatric diseases among urban respondents (Table 1). The length of stay in our study area did not exceed 1 month for most patients. This situation can be explained by the limitation of the capacity of and of the staff of the said hospital structure and which does not exceed about thirty beds, situation like that of Casablanca [7]. This is another challenge for authorities to improve the capacity and quality of care for patients. The annual cadence of the number of new cases is quite high; this is visible in the trend curve that shows an exponential aspect. This result confirmed by several studies is a real wake-up call for the government and the Ministry of Public Health for rapid action is multifaceted to remedy this scourge.
For the schizophrenic sample
Schizophrenia is a serious chronic mental illness, characterized by the loss of contact with reality (Bleuler 1908): false perceptions, false beliefs, abnormalities of thought, emotional blunders, decreased motivation, disorders of social functioning, and source of socio-professional disintegration and emotional isolation [14]. Schizophrenia is the most incriminating mental disorder in the transition to the act of homicide [15], but also suicidal [16, 17]. It occurs most often in late adolescence or early adulthood, which explains why 71% of the schizophrenic cases in our sample were between the ages of 20 and 40. As in our overall sample, the sex ratio value (5.6) is not an exception to the global data that suggest schizophrenia affects as many women as men in the general population [2]. The urbanity that characterizes our sample is consistent with most epidemiological studies that found a higher rate of schizophrenic subjects in urban areas, about twice as high as rural areas [18, 19]. Urbanity can be considered a “marker” of the risk of schizophrenia. The prevalence of schizophrenia in the region over the study period (11 years) is estimated to be approximately 0.5%; the general population in the region being 528,419 according to the last tightening between 2006 and 2016 (https://www.hcp.ma/region-oriental/docs/RGPH2014/29_04_2015.pdf). This result is easily in line with international values, in fact between 0.5 and 2% in France [20], the global prevalence in the general population identified by the World Health Organization is 1% [2]. The exponentially changing trend line reveals the critical situation in the region and suggests rapid intervention by those responsible.
Work limitation: It remains to be noted that the information found in the files is not enough for a more in-depth socio-demographic study.
