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   Table of Contents - Current issue
Coverpage
May-August 2018
Volume 39 | Issue 2
Page Nos. 53-94

Online since Wednesday, May 2, 2018

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ORIGINAL ARTICLES  

Dermatological diseases among patients with psychiatric disorders p. 53
Alshimaa M Abbas Mostafa, Hisham Salah, Reham W Doss, Ahmed E El-Din Arafa
DOI:10.4103/ejpsy.ejpsy_44_17  
Background Skin diseases and psychiatric disorders are related to each other. So, the aim of this research is to study the prevalence and distribution of skin diseases among patients with psychiatric disorders in Beni Suef Governorate. Patients and methods A total of 302 patients with psychiatric disorders attending the outpatient clinic of the Psychiatry Hospital in Beni Suef were assessed for psychiatric and dermatological diseases throughout the period between January 2016 and June 2016. Results Out of the 302 patients, 111 (36.7%) were diagnosed as schizophrenia, 91 (30.2%) with major depressive disorder, 36 (11.9%) with bipolar I disorder, 32 (10.6%) with obsessive compulsive disorder, and 32 (10.6%) with anxiety disorders. Of these patients, 267 (88.4%) had dermatological disorders and infectious dermatological disorders constituted 49.8% of the total skin diseases. Conclusion Skin diseases particularly those of infectious pattern were prevalent among patients with psychiatric disorders.
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Cognitive impairment in elderly depressed and dementia patients in relation to plasma lipids p. 57
Ahmed A Abdel Hamid, Hani H Dessoki, Maged A Gomaa, Mohamed R Soltan, Ahmed A Abdel Hakim, Marwa S Ahmed
DOI:10.4103/ejpsy.ejpsy_1_18  
Objective The aim was to study the relation between plasma lipid severity of cognitive impairment in elderly patients with depression and dementia. Background Cognitive functions are related to changes in lipid profile. Materials and methods Two groups of participants were studied: group A (patient group) included 60 patients subdivided into two subgroups: 30 patients who currently have dementia as a whole without taking into consideration the different kinds of dementia, but after exclusion of vascular dementia, and 30 patients with depressive disorders. Group B (control group) included 30 normal participants selected from among volunteers matched to the patient group for age, sex, education, sociodemographic, and economic status. They were subjected to the following: a psychological assessment that included the geriatric depression scale, the Wechsler memory scale − revised short form, and plasma lipid concentration assessment (overnight fasting blood was collected from each participant by standard venipuncture). Results The results of the study clarified that dementia patients showed more statistically significant impairment in cognitive functions than depressed patients in terms of the Wechsler memory scale − revised. The mean values of the blood cholesterol level, low-density lipoprotein, and high-density lipoprotein in the depressed group were significantly higher than those of the dementia and control groups. Conclusion There is a relation between cognitive impairment in depressed and dementia patients and plasma lipid concentration.
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Cognitive dysfunction profile in a sample of Egyptian patients experiencing major depressive disorder p. 66
Mohammad Khamis Abdel Aal, Tarek Kamal Molokhia, Osama Aboelmagd El Kholy, Hesham A Sheshtawy
DOI:10.4103/ejpsy.ejpsy_28_17  
Aim The aim was to study the profile of cognitive dysfunction in a sample of Egyptian patients experiencing major depressive disorder (MDD), during the relapse phase. Patients and methods Certain cognitive functions (types of attention, short-term memory, processing speed, verbal fluency, and executive functions) were assessed in 30 Egyptian patients diagnosed as having MDD compared with 30 controls. Results There was no statistically significant difference between MDD group and control group regarding scores of digit forward test. Patients’ mean scores of digit backward test, digit symbol test, and semantic fluency test were significantly lesser than the control group’s mean scores of the same tests. On the contrary, patients’ mean scores of trail making test (A and B) were greater significantly than control group’s mean scores of the same tests. Age, duration of education, age at illness onset, number of hospitalizations, and Hamilton score were significantly correlated with impairment of some areas of cognitive functions. Sex, employment, duration of illness, number of previous episodes, and receiving antidepressant medications were not related or correlated with cognitive dysfunction. Increase severity of illness, detected by high Hamilton score, and to a lesser extent, number of hospitalization and duration of education were significant independent predictors for poor performance of the tested cognitive fuctions. Conclusion Selective attention, divided attention, short-term memory, processing speed, verbal fluency, and executive functions are significantly affected in MDD. This can explain the patients’ clinical complaints of difficulty in concentration, easy forgetfulness, and impaired decision making. On the contrary, sustained attention is not affected in patients with MDD. Therefore, the ruminated negative thoughts and memories are manifest complaints in these patients. Severity of illness is the most important predictive factor for discovering cognitive dysfunction symptoms in patients with MDD. Age and age of illness onset are positively correlated with poor cognitive performance; however, they are dependent predictors.
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Does migraine negatively affect cognitive functions? Alexandria University Students Hospital experience p. 73
Samar Sharaf, Mohammad Hamdy, Doaa El-Selmawy, Hesham Sheshtawy
DOI:10.4103/ejpsy.ejpsy_29_17  
Aim Studying the cognitive functions among Alexandria University Students Hospital patients, suffering from common migraine (either newly diagnosed or on regular treatment). Patients and methods A total of three groups were studied: the newly diagnosed migraine group (group I, 20 patients), the chronic migraine group (group II, 20 patients), and the control group (group III, 20 patients). Their cognitive functions were compared using Wechsler Adult Intelligence Scale. Results The mean total intelligence quotient (IQ) scores of chronic migraine group (106.65±4.18) and newly diagnosed migraine group (106.90±4.95) were significantly lower than that of control group (111.35±6.47) (P=0.007). There was no significant difference between mean IQ scores of chronic and newly diagnosed migraine groups. The mean score of newly diagnosed migraine (6.80±1.54) in digit backward subtest was significantly higher than that of chronic migraine group (5.70±1.49) and control group (5.70±2.13) (P<0.05). Conclusion Patients with migraine have worse score than control in total IQ. However, this score is still within the normal limits. This difference may be related to the pain itself. This needs to be scientifically tested in further researches. On the contrary, newly diagnosed migraine group showed worse performance in working memory than chronic migraine group. No difference between chronic migraine patients and control. This denotes that adaptation can improve working memory of patients with migraine with the passage of time.
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Serum uric acid level in drug-naive depressed patients p. 78
Eman S Soliman, Rehab S Mahdy
DOI:10.4103/ejpsy.ejpsy_35_17  
Background Study of the correlation between uric acid (UA) and depression will help to establish evidence for, or against, the new hypothesis stating that the activation of inflammatory, oxidative, and nitrosative stress pathways is a key pathophysiological factor in depression, and reduced antioxidant reserve may coexist with the increased consumption of UA as a scavenger. Objective The aim of this study was to investigate whether serum UA levels are different between drug-naive depressed patients and healthy controls and to compare UA levels in those depressed patients before and after treatment. Materials and methods The serum UA levels and Hamilton Depression Rating Scale scores were estimated in 120 patients with major depressive disorder before and after 5 weeks of treatment with antidepressants. In addition, serum UA levels were measured in 120 healthy controls. Results Drug-naive depressed patients had significantly lower UA levels (3.8±0.93 mg/dl) than the healthy control group (4.57±0.83 mg/dl, P<0.001). We also found that the UA levels of depressive patients increased significantly after 5 weeks of treatment with antidepressants. Conclusion This study presents further proof of the involvement of UA in the pathogenesis and treatment of depression.
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Prevalence and symptoms of premenstrual dysphoric disorder in a sample of psychiatric patients at Zagazig University Hospitals p. 83
Mohammed G Sehlo, Usama M Youssef, Rehab S Mahdy, Hayam El-Gohari
DOI:10.4103/ejpsy.ejpsy_36_17  
Introduction Premenstrual dysphoric disorder (PMDD) is a severe and disabling form of premenstrual syndrome affecting 3–8% of menstruating women. The relationship between PMDD and psychiatric disorders is still unclear. Aim The aim of this study was to assess the prevalence and symptoms of PMDD in a sample of psychiatric patients. Patients and methods A sample of psychiatric outpatients and inpatients who attended for treatment was clinically diagnosed according to Diagnostic and Statistical Manual of Mental Disorders-5 by clinical interview and by applying the premenstrual symptoms screening tool for diagnosis of PMDD. Results The prevalence of PMDD among cases and controls was 40.5 and 7.6%, respectively. PMDD was most prevalent among depressed patients (96.4%) followed by those with bipolar diseases (38.5%) and was less frequent among anxiety and psychotic patients (4.5 and 1.8%, respectively). Conclusion PMDD is highly related to psychiatric disorders especially depression and bipolar disorder.
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Folate, vitamin B12, and negative symptoms in schizophrenia p. 89
Shereen M Abd El Mawella, Hoda A Hussein, Talal Ahmed
DOI:10.4103/ejpsy.ejpsy_39_17  
Introduction Negative symptomatology has been demonstrated to be the most relevant predictor of increased future socio-occupational dysfunction and poorer quality of life. Negative symptoms and functional outcomes have consistently been linked, with several studies reporting worse functional outcomes in individuals with more prominent negative symptoms. Folate deficiency has been identified as a risk factor for schizophrenia and its negative symptoms. Aim The aim of this study was to assess the serum levels of folate and vitamin B12 in a sample of schizophrenic patients and their relation to negative symptoms in these patients. Patients and methods It is a cross-sectional study aiming to assess the serum level of folate and vitamin B12 in schizophrenic patients. All patients were recruited from the Kuwait Center for Mental Health after taking approval from the scientific and ethics committee of the hospital. The study was conducted in the period from January 2016 to April 2016; the total number of patients was 41 after applying the inclusion and exclusion criteria. We applied the Positive and Negative Syndrome Scale and the Scale for the Assessment of Negative Symptoms; serum levels of vitamin B12 and folate were measured by radioimmunoassay technique. Results About 41.5% of the patients have low folate level and about 39% of the patients have low B12 level. There are significant positive correlations between severity of negative symptoms and duration of illness and number of hospital admissions. Also there are significant positive correlations between serum levels of vitamin B12 and folate. There are significant negative correlations between serum levels of vitamin B12. All negative symptoms were assessed by the Scale for the Assessment of Negative Symptoms (affective flattening, alogia, attention, aviolation, and anhedonia). We cannot find a significant correlation between serum levels of folic acid and negative symptoms. Conclusion Folate and vitamin B12 deficiency may be a risk factor for schizophrenia and negative symptoms; so we suggest to evaluate the serum vitamin B12 and folate levels for schizophrenic patients followed by dietary supplementation for patients with low vitamin B12 or folate.
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