Clinical studies have shown greater sex differences in symptoms of schizophrenia, with men having more negative symptoms than women, which may be related to the action of the reproductive hormones.
The aim of this study was to determine the relationship between negative symptoms and the plasma levels of testosterone and dehydroepiandrosterone sulfate (DHEAS) in male patients with schizophrenia.
The participants were 50 male patients with chronic schizophrenia. The psychopathology of the patients was assessed using the Positive and Negative Syndrome Scale (PANSS). The Calgary Depression Scale for Schizophrenia (CDSS) and the Drug-induced Extrapyramidal Symptoms Scale (DIEPSS) were also used to exclude the effects of depression or drug-induced extrapyramidal symptoms.
The PANSS negative scores showed a significant inverse correlation with the serum testosterone levels without a correlation with serum DHEAS.
This study indicates that testosterone but not DHEAS may play an important role in the severity of negative symptoms in male patients with schizophrenia.
Egypt experienced its first nationally televised antistigma campaign in 2007. This independent study aims at a scientific evaluation of the potential benefits of this campaign.
Two educational clips lasting 1 or 2 min each were aired daily on prime time television between 1 and 31 October 2007. Five messages were relayed as the clip rolled on. A specially designed questionnaire covering six areas was used; these included demographics, identifying those who have seen the clips, memory and opinion about each message, stigma-related attitudes, and behavior toward the mentally ill persons. Twenty mental health workers with experience in field work ranging in training from 1 to 13 years received two training sessions. The questionnaire was piloted on 82 participants and subsequently modified. A total of 3000 participants who consented to being interviewed were selected to participate. The data of 2274 participants from the Greater Cairo region are reported in this study (75.8%).
The study sample is more representative of the younger, as only 21% of the sample were above 46 years, educated, as only 18% were illiterate, married, as 55% of the sample were married, and employed sections of the population. A total of 55% reported that daily life stressors were the cause of mental illness. Only 17% of the study sample actually acknowledged seeing the antistigma adverts (campaign exposed, CE) and 83% were campaign unexposed. There were no statistically significant demographic differences between both groups. Among those who saw the campaign adverts, a significant proportion reported a number of positive effects on attitude and behavior. However, when CE and campaign unexposed participants were compared, no statistically significant differences emerged. A total of 50% of the participants remembered that mental illness is curable. The question that psychiatric patients are dangerous to self or others showed a statistically significant difference between participants who were CE and those who were not exposed.
The public were willing to express their opinions as they showed significant cooperativeness and validity of their answers, especially those exposed to the campaign. The television is the medium of choice that the public prefer is the evidence stated in the paper. The antistigma media campaign leads to changes in the attitude of participants who are exposed to mental illness. Positive messages influenced attitude change more.
Bipolar disorder in adolescents is often referred to as juvenile bipolar disorder. A peak in the prevalence of bipolar disorder has been documented between the ages of 15 and 19 years. Wide-ranging neuropsychological deficits have been found in many studies of juvenile bipolar disorder. Persistent neuropsychological deficits present in the euthymic state suggest that such deficits could be vulnerability trait markers of the illness.
To identify and assess cognitive functioning in euthymic adolescents diagnosed with bipolar disorder.
A case–control cross sectional study, in which 30 euthymic bipolar adolescents were recruited from the psychiatric adolescent clinic of Kasr al Ainy and compared with 30 healthy controls.
The Hamilton Rating Scale of Depression, the Young Mania Rating Scale, the letter cancellation test, the digit span and digit symbol/coding tests, the Bender gestalt test and the Wisconsin card sorting test were used.
Cases had significantly higher mean scores than controls in the letter cancellation test and its omission errors as well as in the perseverative errors of the Wisconsin card sorting test, and lower mean scores in the digit span, digit symbol coding and the Bender gestalt tests. There was a significant positive correlation between the number of omission errors on the letter cancellation test and both of the number of manic episodes and the age of onset of the illness.
There are neuropsychological deficits in the areas of sustained attention, set shifting, processing speed and visual and auditory short-term memory in euthymic bipolar adolescent patients, type I. There is a significant correlation between the number of manic episodes as well as age of illness onset and sustained attention.
Executive function (EF) develops throughout childhood and adolescence. Up to half of youth with attention deficit hyperactivity disorder (ADHD) show executive dysfunction. Reading disability has a comorbidity with ADHD of 20–40%. Adequate reading comprehension depends on higher cognitive skills beyond word decoding.
The aim of this study was to investigate EFs and reading abilities in a group of primary school children with ADHD [intelligence quotient (IQ)≥85] and whether they differ with sex.
A total of 30 Egyptian boys and 30 girls aged 8–12 years diagnosed with ADHD were compared with 40 healthy matched controls in terms of clinical assessment of reading skills, comorbidites, IQ, ADHD symptoms using Conners’ Parent Rating Scale-Revised-Long version (CPRS-R-L), EFs using the Wisconsin Card Sorting Test (WCST), and metacognitive reading using the Metacognitive Reading Comprehension Scale.
In total, 50% of ADHD cases showed the combined type, 31.7% the predominantly inattentive, and 18.3% the predominantly hyperactive type, with a significant gender difference (P=0.007). Patients had significantly higher scores in all CPRS-R-L scales, except for the anxious–shy subscale. Boys had higher means in the ‘hyperactivity’, whereas girls had higher means in the ‘cognitive problems/inattention’ scale. Male and female patients did not differ in comorbid learning disabilities but differed in conduct disorder and depression. Patients scored significantly lower on all WCST indices, except the first trials (P<0.001). Girls with ADHD made more errors, P=0.050, and completed less number of categories than boys, P=0.024. EF did not correlate with the hyperactivity subscale of CPRS-R-L. It correlated with the cognitive problems/inattention subscale in male and female patients. The Metacognitive Reading Comprehension scores differed significantly between the children with ADHD and the controls (P<0.001). None of the WCST indices predicted the Metacognitive Reading Comprehension total score. The total score was predicted only by the CPRS-R-L N scale (DSM-IV total), but not by its other subscales, IQ scales, sex, or age.
Children with ADHD have lower EF and reading abilities than controls. Executive dysfunction is related to inattention and not to hyperactivity. No robust differences in EF can be attributed solely to sex. Reading and metacognitive reading dysfunctions showed no gender difference.
High levels of homocysteine are associated with vascular disease, changes in the levels of monoamine neurotransmitters and depression. A plausible hypothesis for these associations is that high homocysteine levels are implicated in vascular disease and neurotransmitter deficiency, which are in turn linked to depression.
To investigate the association between elevated homocysteine levels and depressive symptoms in patients with ischaemic heart disease (IHD).
Eighty patients with a confirmed diagnosis of IHD were consecutively selected in a cross-sectional study from the inpatient and outpatient cardiology department of Kasr-Al-Ainy hospital. All IHD patients were diagnosed according to the criteria of the American College of Cardiology. Depression was evaluated using the Present State Examination-10 Short English–Arabic Version and the Beck Depressive Inventory. The serum level of homocysteine was determined using the chemiluminescent technique.
Thirty-six ischaemic heart patients (45%) had depressive disorders. Depressed patients were older and had a longer duration of the IHD. The level of homocysteine was higher in depressed patients (P=0.098). Positive correlations were found between age and the serum level of homocysteine (P=0.028) but no correlations were found between the serum level of homocysteine and the severity of depression. Sleep disturbances correlated significantly with homocysteine levels irrespective of age.
Depressive symptoms are common in IHD patients, especially patients with prolonged duration of the disease. They are more apparent in IHD patients at times of emergency and intervention. In IHD patients, the serum level of homocysteine is associated with the occurrence of vegetative depressive symptoms.
To study sexual behavior among substance users, to find an association between substance use and risky sexual behaviors, and to determine whether there is an association between personality traits and risky sexual behaviors among substance users.
Our participants (100) were divided into two groups: group 1 (cases) included 50 individuals (diagnosed with substance abuse according to the DSM-VI criteria) recruited from the Kasr El Aini psychiatric inpatient ward and group 2 (controls) included 50 normal control individuals, matched for age, sex, and socioeconomic status. All patients were men, ranging age from 18 to 40 years, were taking substances for at least 6 months, and all of them could read and write. Those with a comorbid axis I diagnosis were excluded from the study. Both groups were subjected to a full psychiatric sheet, risk assessment battery (RAB), and the Eysenck personality questionnaire. The Addiction Severity Index was determined for cases, urine sampling was carried out using drug screening strips, and a laboratory test was performed for HIV and hepatitis C virus detection.
Both groups showed nonsignificant differences in terms of age, education, employment, education, and social status. The most prevalent substance used was tramadol (96%), followed by cannabis (72%) and heroin (58%). Hepatitis C virus infection was detected in (16%); none of the patients had HIV (AIDS). There were statistically significant differences in extroversion and neuroticism between the cases and the controls. There was a statistically significant difference between the cases and the controls in terms of the sexual subscale of RAB. There was a significant correlation between psychoticism and criminality subscales in Eysenck Personality Questionnaire and the RAB in the case group.
Patients with substance abuse have more sexual risk than normal controls. Sexual risk is not related to the severity of addiction, but to psychoticism and criminal behavior of personality.
Schizophrenia is a life-threatening illness with a mortality rate that is twice as high as that of the general population. Over 60% of deaths in schizophrenic patients are due to natural causes such as cardiovascular illness. Patients with schizophrenia and schizoaffective or bipolar disorder may have a predisposition to metabolic syndrome that is exacerbated by a sedentary life, poor dietary habits, possible limited access to care, and antipsychotic drug-induced adverse effects. It has been found that the prevalence rate of metabolic syndrome among schizophrenic patients ranges from 32 to 51%, with a two- to three-fold higher mortality rate due to heart attack compared with those without metabolic syndrome.
The current study aimed at detecting the prevalence and patterns of metabolic syndrome in chronic institutionalized patients with schizophrenia, comparing patients with metabolic syndrome - defined by different criteria- and lastly trying to find the predictor factors for metabolic syndrome and for diabetes mellitus.
Ninety-five patients with schizophrenia and schizoaffective disorder were recruited from long-stay hospital wards, were interviewed using structured clinical interview, and were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, 4th ed. They were subjected to a cross-sectional assessment by psychopathological rating scales including positive and negative syndrome scale, mini mental state examination, and clinical global impression – severity index scale and also to anthropometric measurement taking (BMI and waist circumference). Sociodemographic and clinical characteristics as well as treatment history were collected from data files. Cases were classified into four groups according to the International Diabetes Federation criteria: definite cases with metabolic syndrome (IDF criteria); the high-risk group (lacking one criterion); risky cases with risk for central obesity; and patients with no apparent risk. Data were collected and statistically analyzed.
Twenty-two patients (23.15%) had definite metabolic syndrome according to IDF criteria, 47 patients (49.4%) had high risk, 17 patients (17.8%) had risk factors of metabolic syndrome, and only nine cases (9.4%) had no apparent risk for metabolic syndrome. Sociodemographic and clinical characteristics and psychopathological rating scores were not predictors for metabolic syndrome, nor for diabetes mellitus. BMI and waist circumference had the highest sensitivity, predictive value, and diagnostic accuracy for metabolic syndrome compared with the presence of diabetes, hypertension, or dyslipidemia. Diabetes mellitus occurred earlier and was of longer duration compared with other metabolic disturbances.
(1) The high risk of MS among patients with chronic schizophrenia mandates careful monitoring and elimination of risk factors. (2) BMI and WC as well as blood sugar and lipid profile are considered simple measures for detecting risk factors. (3) Attempts towards toward eliminating risk factors such as poor lifestyle, obesity, and metabolic disturbances is vital for long stay hospitalised patients.
The aim of the study was to assess cognitive functions, depression, anxiety, and personality changes in workers in the aluminium industry.
A cross-sectional analytical study was carried out on 50 workers employed in ‘General Metal Company’, which manufactures aluminium. Fifty individuals with no history of occupational exposure to aluminium were randomly selected from relatives of patients attending the outpatient clinic of industrial medicine in Kasr Al Aini hospital to form a control group. Both groups were matched for age and sex. All of the examined individuals were subjected to clinical, laboratory and environmental examinations that included aluminium and copper dust measurement, noise measurement and heat measurement. The workers were diagnosed according to the ICD-10 research diagnostic criteria. Both groups were subjected to different neuropsychological tests that included the Mini Mental State Examination (MMSE), the Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HARS), the Eysenck Personality Questionnaire (EPQ) and the Wechsler Memory Scale (WMS).
The results showed that serum and urinary aluminium levels were higher in the exposed group when compared with the control group (nonexposed group), with highly statistically significant differences. However, there was no statistically significant difference between the groups with respect to serum copper. There were statistically significant differences between them in all subtests of the WMS (information, orientation, logical memory, digit span and associate learning) except with respect to mental control. Most cases were within the normal range of values according to MMSE, but there was a statistically significant difference. There was a statistically significant difference between the exposed and control individuals as regards all subscales of the EPQ (psychotism, neurotism, extroversion, lying and criminality). Seven per cent of workers had severe depression, 11% had moderate depression and 25% had mild depression in the exposed group, whereas 20% had mild depression in the control group. There was a statistically significant difference between the exposed and control group with respect to depression. Six per cent of workers in the exposed group had severe anxiety, whereas 30 and 34% had mild and moderate anxiety levels, respectively. There was a highly statistically significant difference between the exposed and control groups with respect to anxiety. There was statistically significant negative correlations between serum and urinary aluminium level and the information, logical memory and digit span subtests of the WMS. Serum copper shows no significant correlations with all subtests of Wechsler Memory Scale (WMS). The increase in serum and urinary aluminium levels led to a decrease in the scores of MMSE (a negative correlation, which was statistically significant). In contrast, serum copper showed no statistically significant correlation with the scores on MMSE. There was no statistically significant correlation between metal levels in the exposed group (serum aluminium, urinary aluminium and serum copper) and any of the parameters of the Eysnek personality test, apart from criminality, which seemed to have a statistically significant positive correlation with serum aluminium level. There was a statistically significant positive correlation between serum aluminium and HDRS, whereas there was no statistically significant correlation between urinary aluminium and serum copper with HARS. There was a statistically significant positive correlation between serum aluminium and the HARS. With respect to urinary aluminium and serum copper, there was no statistically significant correlation with the HARS.
The study showed that exposed workers in the aluminium industry are suffering from cognitive decline, memory affection, depression, anxiety and personality changes. Proper monitoring and improved hazard control are strongly recommended.
To assess the efficacy of the psychoeducational program in alleviating cancer-related fatigue and mood symptoms, and improving quality of life of breast cancer survivors.
A prospective follow-up case–control study was carried out between June and December 2010. Eighty patients were randomly selected from among women who had recently completed their treatments for breast cancer at the outpatient clinic in the Department of Clinical Oncology, Cairo University (Egypt). They were divided into group A, which received the program, and group B, the waiting control group. Karnofsky Performance Scale was used to exclude physical disability. Assessment was carried out twice, at weeks 0 and 4, using Hospital Anxiety and Depression Scale (HADS), Health-Related Quality of Life-Short Form (HRQL-SF) 36, and Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF). The psychiatric diagnosis was made according to the Diagnostic and Statistical Manual of Psychiatric Disorders, 4th ed., Text Revised criteria.
There was a nonsignificant difference between both groups in terms of sociodemographic or medical data, and the mean scores of HADS, HRQL-SF 36, and MFSI-SF at week 0. There was a significant difference between both the groups in terms of the mean scores of HADS, HRQL-SF 36, and MFSI-SF at week 4. There was a significant difference between the mean scores of HADS, HRQL-SF 36, and MFSI-SF in group A before and after the intervention.
Fatigue is a major problem in the majority of breast cancer patients after therapy. A psychoeducational program improves various aspects of patients’ physical, emotional, and quality of life.
The present study was carried out to investigate why psychiatric and psychological examinations are neglected during periodical medical examinations for football referees.
A total of 42 certified male referees were randomly selected from the Sports Medicine Specialized Center situated at Nasr City, Cairo Governorate, Egypt. All participants were registered at the African Confederation of Football. Male adult referees with ages ranging from 29 to 43 years were included in the study. Questionnaires related to the demographic personal characteristics, anxiety, physical health, stress, burnout, and depression were filled out by the participants.
The mean age of the participants was 40±3.35 years. Of the participants, 34 were unmarried and eight were married; 32 participants did not have children and 10 did. A total of 36 participants had recieved higher education and six recieved only high school education. Participants were under moderate training schedules of 5 sessions/week of 1½–2 h each and had moderate years of experience (30–50 matches/year). With regard to the Burnout Anxiety Inventory, 63.3% of the participating referees showed no signs of anxiety, 18.4% were at borderline, 15.9% showed mild signs, and 1% presented with moderate records. With regard to the mind over mood depression scores, 35 participants showed no signs, whereas only two showed low signs. The Beck Depression Inventory scores of all participants was in the range of 0–7, that is, they had normal levels of depression. The physical wellness scores of 31 participants were recorded as excellent, whereas five recorded only average scores. With respect to the life stress scores, 67% of participants had normal life stress scores compared with 33% who were more prone to suffer or experience illnesses or accidents from life stress incidents. The Burnout Inventory scale revealed that 47.05% of participants had little signs and 52.95% showed low signs of burnout, with none being at risk. The Maslach results were also in concordance, according to which only one referee suffered from a burnout.
Thus, it may be deduced that, although the present levels of burnout may not be high, there is always potential for it to increase. Thus, programs on burnout are suggested to be included in training courses for referees to prevent the start of symptoms. It is therefore recommended that physical checkup be supplemented with psychiatric and psychological examinations in the periodical assessments of physical health for football referees.
Central auditory processing disorders and attention deficit-hyperactivity disorders (ADHD) have become popular diagnostic entities for school-age children. P300 (P3) event-related potential (ERP) putatively reflects central auditory dysfunctions associated with ADHD.
Forty children with a diagnosis of ADHD according to Diagnostic and Statistical Manual of Mental Disorders, 4th ed. and 39 normal children were included in the study and were subjected to P300 ERP, audio-vocal items of Illinois test of psycholinguistic abilities.
This study found a significant difference in P300 latency, amplitude, and most of the audio-vocal subtests between the patients and the controls. This difference was obvious in older children for the Illinois test, but was not observed in P300 results.
There was a CAPD in ADHD children as indicated by decreased amplitude of P300 and prolonged latency in such children.