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.
To describe the characteristics of informal caregivers of terminally ill (hepatic, cardiac, and renal failure) patients and their care recipients and to examine the relationship between depression, anxiety, and burden among informal caregivers.
This was a cross-sectional study, in which 51 caregivers of terminally ill (hepatic, cardiac, and renal failure) patients were recruited from among inpatients of Internal Medicine Department, Kasr Al Aini, Faculty of Medicine, from September 2011 to April 2012. The patients were subjected to a Caregiver Questionnaire, Hamilton Anxiety Rating Scales, and Hamilton Depression Rating Scales, and the Modified Caregiver Strain Index was determined.
Most of the caregivers experienced high levels of burden, severe anxiety, and mild depression. Several factors showed a statistically significant correlation with caregiver burden, anxiety, and depression including the care recipient’s functional status, personality changes, mental functioning, the presence of comorbidity, the Palliative Prognostic Score, being the main caregiver, duration of caregiving, the caregiver’s employment status, perceived health, and impact on social activities. Caregiver burden, anxiety, and depression were significantly correlated.
Caregivers of terminal organ failure (hepatic, cardiac, and renal) patients experience high levels of burden, severe anxiety, and mild depression. Predictors of anxiety, depression, and burden include being the main caregiver, duration of caregiving, the caregiver’s employment status, perceived health, and impact on social activities.
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.
In many western countries, deinstitutionalization of chronically mentally ill patients was established after the mass introduction of neuroleptics in the late 1960s and the early 1970s. Deinstitutionalization was proven to be successful when there were strong ideological or humanitarian motives and when psychiatric reform was a priority and was completed with a comprehensive system of community. However, its long-term effects should be examined and questioned in terms of improving quality of life and functional abilities.
The research aimed at studying the morbidity profile and impact of schizophrenia on chronic institutionalized mentally ill patients as baseline data for planning of deinstitutionalization and a Community care program.
Data on sociodemographics, course of illness, treatment history, rate of admission, duration of hospital stay, and medical condition were collected retrospectively, followed by a cross-sectional study of a total of 95 patients with a schizophrenia spectrum using psychopathological rating scales such as PANSS, MMSE, CGI-S. Diagnosis according to DSM-IV and an interview using SCID were carried out by two different psychiatrists for high inter-rater reliability. The sample was recruited from among long-stay hospital patients.
The mean age of onset of schizophrenia among the patients was 48.9±10.3 and 21.2±5.7 years. The mean duration of illness was 27.5±9.3 years, whereas the mean duration of repeated admission was 19.07±12.5 years. With respect to the median percentage of total hospital stay, 30% could be attributed to the patients’ median age and 55% to illness duration, whereas with respect to chronic hospitalization 20% could be attributed to the patients’ median age and 35% to illness duration. Of the patients, 85% were men; 70% were single and unemployed with a low socioeconomic status; 25% lacked private housing; 30% had diabetes mellitus and/or hypertension; 80% were obese and overweight; and 50% were on antilipid drugs. Delusion, hallucination, and conceptual disorganization were the highest-scoring positive symptoms in 50% of cases. Negative symptoms also scored higher (7.4) on all items in 60% of cases. Eighty percent had compromised cognitive deficits. Early age of onset of schizophrenia and being older were powerful predictors for repeated admission, a long duration of illness, and chronic hospitalizations. Severity of illness is also a powerful predictor for long hospital stay.
Schizophrenia is a chronic devastating illness that impacts function and cognitive abilities, and is characterized by a high rate of admission, chronic course of illness as well as chronic institutionalization. For continuity of care and a favorable prognosis, early comprehensive, multidisciplinary, and multimodel programs are required for patients with mental illness from the date of first hospital contact.
The aim of the current study was to assess the relation between working memory dysfunction and clinical and MRI findings in relapsing remitting multiple sclerosis.
This study was conducted on 50 patients with clinically definite relapsing remitting multiple sclerosis, they were recruited from the Outpatient Clinic of Alexandria University Hospitals; and 25 healthy controls matched for age, sex, and educational level. All participants were subjected to neuropsychological assessment that included: digit span, visual span, N-nack task, and Wisconsin card sorting test. The patient group was further subjected to: Expanded disability status scale (EDSS) and brain MRI.
Clinically, the present study found no statistically significant correlations between working memory dysfunction and age, age at onset, sex, number of relapses, affected functional system, or EDSS status. Alternatively, there were statistically significant positive correlations between working memory dysfunction and the duration of illness.
This study suggests that according to the resources utilized by cognitive tasks, working memory tasks may be classified into high-demanding working memory tasks (2-back task and WCST) and low-demanding working memory tasks (1-back task and digit and visual span), and in relapsing remitting multiple sclerosis working memory dysfunction includes mainly high-demanding working memory tasks.
To evaluate the effectiveness of combined methadone maintenance treatment and psychosocial treatment program for heroin-addicted patients.
Forty-eight heroin-dependent participants were interviewed using the Addiction Severity Index (ASI), 5th ed., and the Mini International Neuropsychiatric Interview during the first week of their admission to a methadone clinic in Los Angeles, California, for baseline assessment. A follow-up ASI assessment was made 6 months after their first interview.
ASI revealed that 67% of participants reported chronic medical problems, 69% were unemployed, 94% had been incarcerated, and 71% had suffered from psychiatric symptoms in the past 30 days, the most common being anxiety and depression. Female participants reported significantly more severe medical, employment, and psychiatric problems than did male participants. The Mini International Neuropsychiatric Interview revealed that 63% met criteria for the presence of one or more current psychiatric disorders. By the time of follow-up investigation, 15 participants had dropped out of the study. Participants who were still in treatment showed significant improvement in their medical, drug, legal, family, and psychiatric problems compared with their baseline assessments.
Combined methadone treatment and psychosocial treatment worked well for most of the participants of both sexes with or without comorbid psychiatric disorders.
The relationship between mother and child develops and progresses throughout the pregnancy period. In recent times there has been increasing interest in antenatal maternal–foetal bonding and its relationship with different variables, as well as the impact of this bonding on the child’s mental health.
To investigate the pattern of maternal–foetal relationship during pregnancy, and its relationship to maternal depression and to different sociodemographic and pregnancy-related factors, as well as to the perception of intimate relation with spouse.
One hundred expectant Egyptian mothers attending obstetric outpatient clinics for regular follow-up of their pregnancy were recruited into the study. They were asked to fill the Maternal–Fetal Attachment Scale (MFAS), the Intimate Bond Measure and the Edinburgh Postnatal Depression Scale.
Maternal antenatal bonding was significantly higher on the MFAS in expectant mothers with longer gestational age. Women with assisted pregnancy had significantly higher scores on the MFAS total score and Role Taking and Attribution subscales. However, if the cause of infertility was unexplained or related to female-oriented factors, the aforementioned MFAS scores tended to be significantly lower than when infertility was related to male-oriented or both factors. Primiparous women had significantly higher scores on the MFAS total score and Role Taking and Differentiation subscales compared with multiparous women. Women who perceived themselves as being healthy had significantly higher scores on the Interaction subscale of MFAS. In this study the intimate relationship with the spouse, and not the marriage duration, showed significant differences in relation to maternal bonding. Expectant mothers who reported a positive attitude towards their marital relationship (Optimal Intimacy and Affectionate Constraint) had significant higher means on the total score of the MFAS and on the Interaction, Giving of Self and Role Taking subscales. The study showed that expectant women with previous loss of foetus and those with no depressive symptoms had better bonding despite the lack of significance.
Maternal antenatal bonding is associated with multiple factors including longer gestational age, parity, previous loss of foetus, assisted pregnancy, perceived good maternal health and intimacy with partner.
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.