The sample consists of 714 (430 boys and 284 girls) subjects of adolescents population from high schools of different sectors. The mean age was 17.39 years (SD = 1.47), range: 15 and 21 years (Table 1). Moreover, the participants were selected because they reflect a representative sample of the adolescents population’s study of high schools in Kenitra (which is selected randomly). Our sample

divided into three sections: modern letters, experimental sciences (biology, geology, physics, and chemistry) and mathematical sciences.

For ethical considerations, participants informed of the anonymity of the study and the possibility of refusal to participate. While the self-questionnaire explained the interest of the study, its anonymity and the possibility of refusal of participation. The agreement of the provincial delegates of the Ministry of National Education and Vocational Training and the directors of the establishments concerned was obtained.

This study took place in high schools in the Kenitra city of Morocco. We collected the data in the form of group handouts in a school classroom with 20 students, in the presence of the investigator with the objective explanation of the study. Both tests were translated into Arabic and, if necessary, some questions were explained in simple terms and accessible to all (in dialectal Arabic). To avoid any bias, a period outside exams, parties and school holidays was chosen. The investigation began on January 13, 2018 and lasted 6 days.

Coding, processing and statistical analysis of the data were done with Excel 2013 software and SPSS V.17 software. The statistical tests used were: χ² and Student’s t-test. The tests were considered significant for a degree of significance “p” less than or equal to 0.05.

Regular consumption of tobacco is 16.38% (14.52% are girls and 85.47% are boys); cannabis is 6.72% (1.7% are girls and 95.83% are boys); and alcohol is 5.88% (2.56% are girls and 92.86% are boys). The χ² test allowed us to highlight a significant difference between girls and boys regarding the prevalence of consumption of the three PAS (Table 2).

From the scale, anxiety and depression scores were found to be higher among student consumers (M = 16.57 ± 5.87 (0 - 28)) than non-users (M = 14.4 ± 4.60 (0 - 27)). Student’s t test allowed us to show a significant difference between non-consumers and consumers (t = 4.309, p < 0.000) (Table 3).

The prevalence of smoking in the group of adolescents in the Kenitra region is 16.38%. This prevalence is similar to that of school-based studies, particularly among secondary school and college students, who show smoking prevalence ranging from 6.5% to 15.4% [13] [15] [16] . As well as that report in the National Program for the Evaluation of Acquired Students (NPEA) report 2016 [21] which is 15%. However, this prevalence remains inferior to those reported by international studies, which are 30% [22] , 34% [23] and 32.4% [10] . In the sample studied, 6.72% of the students reported having used cannabis and 5.88% of the alcohol regularly during the last 30 days, these results were close to the one reported in the MEDSPA 2014 [12] survey prevalence of cannabis and alcohol during the last 30 days, were successively 4.7% and 3%). However, the NPEA (2016) [21] has higher prevalence: 13% use drugs within the establishment and 10% use alcohol. In addition, the 2014 ESCAPAD survey [10] interviewing 26,351 French adolescents shows a higher regular use of alcohol, which concerns 12.3% of respondents, and comparable for that of cannabis use 4%.

Studies of the prevalence of psychoactive substance use clearly show that not all types of psychoactive substances consumed in the same way or at the same age. This is all the more important to take into account that the trajectory of changes in consumption depends on the type of psychoactive substance consumed [24] [25] [26] .

The two tests selected for the search for depressive syndrome (HADS and ADRS), are designed to identify a depressive syndrome in adolescents and measure its intensity. They give an assessment of the depressive symptomatology according to three cases: absence of disorders or of risk, susceptible disorders or moderate risk and severe disorders or risk.

However, whatever the test administered, our study, like most surveys conducted in children and adolescents, shows prevalences affirming the existence of depressive symptomatology at this period of life. Thus, for the non-consumer population the absence of depressive symptomatology estimated between 41.10% and 80.55%; suspicious disorders between 13.21% (HAD-D) and 22.94% (ADRS) and severe disorders at 6.24% (HAD-D). However, for teenagers, the absence of disorders concerns 66.67% (HAD-D); suspicious disorders at 20.83% (HAD-D); while severe disorder is estimated to be between 8.28% (ADRS). These results remain close to that of the national survey of the Ministry of Public Health, which reported that 48.9% of Moroccans suffer or have already suffered from mental disorders [27] . Moreover, that which appears in the report of the National Council of Human Rights in 2012, which announces that 48% of Moroccans suffer from mental disorders, 26.5% of them are victims of depressions [28] .

Although the depressive signs are present in the adolescent population as in the literature, the lack of data concerning Moroccan adolescents suffering from such a disorder doesn’t allow comparing the results obtained with other adolescents presenting the same socio-cultural framework. Moreover, depressive and anxiety disorders represent the most frequent psychiatric diagnosis in children and adolescents [29] [30] . Hence the importance of their evaluation in this study. They are generally comorbid and overlap with symptoms, causes and consequences [31] . Furthermore, the result obtained concerning the prevalence of anxiety symptomatology confirms the suffering of the adolescents of such a disorder, independently of the consumption of the PAS. Since among the non-consuming subjects this prevalence is estimated between 10.83% for the suspect disorders and 7.89% for the troubled disorders; these values belong to the interval reported by several studies and vary between 8% and 30% during life [32] .

Otherwise, a comparison of the two groups of adolescents studied reveals that the presence of anxious symptomatology is significantly greater in teenagers who use PAS (p = 0.001). This result is confirmed by numerous studies [23] [33] [34] . Thus, the research of Sonntag et al. (2000) [35] find that in social phobia, which is the most common pathology among anxiety disorders, smoking is twice as common and often associated with alcohol. Moreover, comorbidity, between cannabis use and anxiety symptoms, has been found in several epidemiological and clinical studies in adolescents. There is a link between the use of psychoactive substances and psychopathological symptoms such as anxiety [36] . On the other hand, the lack of an apparent relationship between cannabis use and anxiety does not exclude that anxiety may favor consumption, as this possibility may be masked by the anxiolytic effect of cannabis [37] , and depressive disorders represent the common mental health problem in adolescents worldwide [38] . According to the study of Flament et al. (2001) [39] , 20% of adolescents may have depressive symptomatology, too often considered a transient adolescent crisis.

While in France in 2014, it is estimated that a quarter of adolescents aged 17 had a depressive syndrome (moderate for 20.8% and severe for 5.3% of them) [40] . These results are similar to those of the present study, since (according to the evaluation of the HAD-D test) the assessment of the depressive symptomatology in adolescents who do not consume PAS is estimated at 13.21% for suspicious disorders and 6.24% for proven troubles.

The comorbidity between depressive symptomatology and PAS consumption has been the subject of several epidemiological studies [23] [41] [42] . In addition, diagnosis of depressive or anxious states in childhood or adolescence is associated with a greater risk of substance abuse [41] [43] . Thus, depression at a young age is positively associated with substance abuse [44] [45] . Gomes found a strong relationship between psychoactive substance use and depression in adolescence [46] . Other clinical studies in adolescents have reported the association between substance use disorders, major depression and personality disorders [47] . In this regard, the results of the various scales (HAD-D, ADRS) to identify the prevalence of adolescents possibly depressed have revealed that teenagers consuming PPS appear more depressed since the expression of depressive symptomatology is more important in them. Moreover, a positively significant difference in the scores of each tests in the PAS and non-consumer consumers noted.

On the other hand, many studies highlight the co-occurrence of depressive disorders and a significant consumption of psychoactive substances in adolescence [48] [49] [50] [51] . This co-occurrence of depression and substance abuse is associated with greater severity and duration of both problems [45] [52] . Moreover, the results of Janssen’s work show in 17-year-olds a marked gradient between substance use level and depressive severity [40] . When regular polydrug consumption of tobacco, alcohol and/or cannabis increases significantly with the degree of severity of depression in the adolescent population, co-occurrence of these uses does not mean that they are concomitant [40] .

Otherwise, the observation of criteria of anxiety and depression is more frequent among smokers than non-smokers [32] [33] [34] . Moreover, one study found an increased risk of depression among tobacco users, a significant risk of increasing tobacco use with depression, and the existence of common genetic [53] and neurobiological factors predisposing both to smoking disorders [54] . While other research on the adolescent population shows that depressive symptomatology in adolescence is associated with smoking and alcohol abuse [55] [56] , and that depressed adolescents speculate that the use of substances can conclude benefits [57] . In this regard, it noted in the results obtained by the HAD-D test that adolescent smokers had the highest scores on the expression of depressive states and that cannabis users had the lowest; this can either reveal the antidepressant effect of cannabis, or suggest that depressive symptomatology tends to protect against the risk of consumption. It may also result from these two effects, with some depressed subjects using cannabis as self-medication and other depressed subjects avoiding cannabis use more than non-depressed ones, due to anxiety, a tendency to guilt, or diminished ability to seek out experiences of pleasure [37] .

This finding does not contradict the positive links between cannabis use and the presence of depressive symptomatology both in the present work and in other studies such as that of Troisi which showed that the frequency of psychiatric disorders, especially depressive disorders and anxious, was correlated with the importance of cannabis use in young adults [36] . Or the longitudinal study in adults of Bovasso, which showed that subjects without depressive symptoms at baseline and using cannabis had a 4-fold higher risk of developing depression than subjects without initial depression who did not consume alcohol cannabis, as well as psychiatric symptoms or disorders [58] .