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   Table of Contents - Current issue
Coverpage
May-August 2022
Volume 43 | Issue 2
Page Nos. 63-124

Online since Friday, June 24, 2022

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REVIEW ARTICLE  

Oxytocin and obsessive–compulsive disorder p. 63
Mohamed R Soltan
DOI:10.4103/ejpsy.ejpsy_28_21  
Attention has recently been focused on central nervous system neuropeptides as potential mediators of the symptom profile of obsessive–compulsive disorder (OCD). OCD includes a range of cognitive and behavioral symptoms that bear some relationship to dimensions of behavior associated with oxytocin (OT). Increased cerebrospinal fluid levels of the anxiolytic neuropeptide OT have been reported in OCD. OT is a neurosecretory nonapeptide synthesized in hypothalamic cells, which project to widely distributed sites in the central nervous system as well as the neurohypophysis. Central OT affects a variety of cognitive, grooming, affiliative, sexual, and reproductive behaviors in animals. OT is associated with the regulation of complex sociocognitive processes such as attachment, social exploration, social recognition, anxiety, and other stress-related behaviors. Based on these data, we hypothesized that OCD is mediated by OT. The aim of this review is to define possible involvements of OT in the pathophysiology of OCD.
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ORIGINAL ARTICLES Top

Psychological effect of the COVID-19 pandemic on a cohort of Egyptian population p. 70
Salma M Ragab, Amira Ibrahim, Aya M Mahrous, Mohamed Z Gomaa, Hebat A.A Maksoud, Hassan El-shirbiny, Mohamed Naguib, Mohammed H Ahmed
DOI:10.4103/ejpsy.ejpsy_40_21  
Background The current coronavirus disease (COVID-19) pandemic has had a great effect worldwide. Although health care workers (HCWs) play an essential role and are one of the most exposed groups, information about the psychosocial effect among the general population and those who came in contact with COVID-19-infected patients is still required. Aim The study’s main aim was to assess the prevalence of anxiety and depression among the general population, those who came in contact with patients, and frontline HCWs in response to the COVID-19 pandemic in Egypt and to investigate factors associated with psychological distress. Materials and methods A cross-sectional study was carried out using an online-administered questionnaire. The questionnaire included sociodemographic data and data related to the current pandemic. Hospital-based anxiety and depression scale (HADS)-Arabic version was used to assess anxiety and depression. Multivariable logistic regression analysis was performed to identify significant predictors. Results A total of 1778 participants were involved in the current study, and of them, 82.6% were general population, 10.6% were HCWs, whereas those who came in contact with COVID-19-infected patients were 6.8%, with more female predominance. Of 1778 participants, 711 (40%) had abnormal depressive score. Overall, 52.9% of those who came in contact with COVID-19-infected patients had abnormal depressive score, whereas 39.4% and 36.5% of the general population and HCWs, respectively, had abnormal depressive score, with statistically significant difference. Regarding anxiety, there was a highly significant difference among the three groups with higher abnormal anxiety score among those who came in contact with COVID-19-infected patients (46.3%) than the general population and HCWs (33% and 33.9%, respectively). Overall, 34% of all participants had abnormal anxiety score. While evaluating different parameters associated with psychological distress by multiple logistic regression analysis, individuals without a history of previous psychological illness and those who rely on internet and approved sites as sources of information experienced less anxiety and depression. Female sex and lower levels of education have a higher risk of anxiety. Conclusions During the current pandemic, the Egyptian population has a high prevalence of psychological distress, with a higher prevalence among those who came in contact with COVID-19-infected patients than in the general population and HCWs. Among different parameters associated with psychological distress, individuals without a history of previous psychological illness and those who rely on internet and approved sites as sources of information experienced less anxiety and depression during the COVID-19 pandemic. Therefore, establishing early targeted mental health interventions should become routine as a part of our preparedness efforts.
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Relationships between suicide intention, cognitive styles, and decision making in attempted suicide p. 80
Suhruth Reddy, Dushad Ram
DOI:10.4103/ejpsy.ejpsy_32_21  
Background This study suggests a link of suicidal intention with cognitive styles and decision making. There is a paucity of studies examining these relationships from a multidimensional perspective. Aims This study aimed to examine the relationships of suicide intention, cognitive styles, and decision making in serious suicide attempts. Participants and methods One hundred individuals with serious suicide attempts were assessed in this hospital-based cross-sectional study using sociodemographic and clinical questionnaires, the Mini-International Neuropsychiatric Interview-Plus (MINI-Plus), the Pierce Suicidal Intention Scale (PSI), the Melbourne Decision Making Questionnaire, and the Cognitive Style Inventory. Results The common dimensions of cognitive styles were systematic, undifferentiated, and split. The PSI score was statistically significantly predicted by the vigilance (positive) and buck-passing scores in a linear regression analysis (negative). There were no significant relationships between the PSI score and cognitive styles. There was a statistically significant group difference in the Melbourne Decision Making Questionnaire vigilance score by systematic, undifferentiated, and split cognitive style dimensions in the Mann–Whitney U-test. Conclusion Systematic, undifferentiated, and split cognitive styles are prevalent in serious suicide attempts. Rational decision making may be proportionate to the severity of suicide intent, but is constrained by the scarcity and static nature of cognitive style in attempted suicide.
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CRP and its relation to cognitive performance in schizophrenia patients: a cross-sectional study p. 87
Sanaa Ahmed Kamal, Sarah Adel Abdel-Monem El-Samahy, Walaa Abdelfattah, Ola Osama Khalaf
DOI:10.4103/ejpsy.ejpsy_44_21  
Background Schizophrenia (SZ) is one of the most severe and chronic forms of mental illness. It involves cognition, emotion, perception, and behavior. There is an obvious role of neuroinflammation and immunogenetics in SZ. There is a relation between the severity of cognitive deficits and enhanced levels of inflammatory markers in schizophrenic patients, including C-reactive protein (CRP). Also, a relation between CRP and the negative-symptom subscale of Positive and Negative Syndrome Scale (PANSS) was observed. Aims To study the relation between CRP level with different cognitive domains in patients with SZ and its relation to the psychopathology of SZ. Methods A cross-sectional study was applied on 40 SZ patients and 40 healthy controls, serum CRP was measured, and they were cognitively assessed using Arabic version of Montreal Cognitive Assessment Basic (MoCA-B). Results SZ patients showed worse cognitive performance on all subtests (except orientation), MOCA-B, and the total score when compared with normal controls. A negative correlation between executive functions, calculation, abstraction, memory, naming, and attention subtests of MoCA-B and its total score with the serum CRP was found. A positive correlation between CRP and the negative subscale and total score of PANSS was found. Conclusions Serum CRP level was elevated in patients with SZ when compared with healthy controls and significantly negatively correlated with cognitive functions, and positively correlated with negative symptoms in SZ patients, which seconds the neuroinflammatory etiology of SZ.
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Impulsivity in tramadol dependence and bipolar I disorder patients: a comparative study p. 94
Mostafa O Shahin, Mohamed E.S El Taweel, Muhammad R Suleiman, Dina B Taher
DOI:10.4103/ejpsy.ejpsy_45_21  
Background Tramadol has become widespread in Egypt. Impulsivity is recognized as a factor in the initiation and maintenance of substance use disorders. Moreover, bipolar disorder (BD) is commonly associated with impulsivity. Impulsivity seems to be relatively independent of mood state and is higher in individuals with past history of substance use. So, comparing impulsivity in BD and tramadol dependence is needed to determine if there is any difference. Impulsivity was evaluated by the Barratt Impulsiveness Scale in 30 male patients with BD in partial remission without any comorbid substance use disorder and age-matched 30 male patients with tramadol dependence in partial remission. Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID1), addiction severity index, Young Mania Rating Scale, andEysenck’s Personality Questionnaire were used. Results There was no difference among BD and tramadol dependence groups of patients on subscales attentional and motor impulsivity measures. However, the male tramadol dependence patient group scored higher than the male BD patient group for total and nonplanning impulsivity scores. Conclusion This study found that BD and tramadol dependence patients were similar on attention and motor impulsivity subscales but on the total score and nonplanning subscale, patients with tramadol dependence are more impulsive than patients with BD. Increased tendency to criminal behavior is associated with the increase in total and motor scores of Barratt Impulsiveness Scale in tramadol dependence patients as well as with the total scores of Young Mania Rating Scale in BD patients. Moreover, the severity of mania is correlated with the attentional domain of impulsivity.
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Awareness of sexual medicine among a sample of mental health providers p. 101
Mona Reda, Mohammad G Sehlo, Usama M Youssef, Dina A Seleem
DOI:10.4103/ejpsy.ejpsy_43_21  
Back ground Routine sexual history taking is an important component of psychiatric case formulation, and while sexual health problems are common, they are often left underdiagnosed in clinical practice. This study aimed to identify Egyptian mental health professionals’ knowledge, skills, and attitudes toward sexual medicine and psychosexual history taking. In this cross-sectional online survey study, 242 mental health professionals (160 psychiatrists and 82 psychologists) currently practicing in Egypt completed the survey. Results About 98.3% of surveyed professionals were in agreement that collecting sexual history is vital to efficient clinical assessments. However, nearly half the participants believed that they lacked sufficient knowledge (51.7%) or clinical experience (50%) in psychosexual health matters, and one-third (34.7%) did not believe that they are confident in managing such problems. More than half (56.4%) do not routinely initiate taking sexual history, and about one-fifth (20.6%) were not comfortable initiating such questions. Common barriers included inadequate education and training (49.2%), irrelevance to patient’s chief complaint (39.7%), limited time (38%) and privacy (34.7%), worry of offending the patient (28.5%), feeling of awkwardness (27.3%), lack of confidence (24%), and to a lesser extent, poor rapport (15.3%) and fear of being judged by the patients (10.3%). Conclusion Egyptian mental health professionals do not routinely discuss sexual health issues with their patients, despite understanding its importance, due to multiple social, educational, and personal barriers. Perceived lack of knowledge, limited clinical experience, personal difficulties, and social constraints are considered the main barriers.
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Impact of maternal depression and social factors on child’s nutritional status: a case–control study in Egypt p. 108
Maha A Hassan, Gihan M Bebars, Salwa M.R Taha
DOI:10.4103/ejpsy.ejpsy_35_21  
Background Malnutrition is a primary cause of child morbidity. Maternal depression affects children’s health, especially nutrition. Aim This study aimed to explore the effects of maternal depression and social factors on children’s nutrition. Patients and methods A case–control study was carried out on 100 children and their mothers: 50 malnourished children and 50 age-matched and sex-matched healthy-control children. Anthropometric measurements of children were done and transformed into weight-for-age and weight-for-height Z-scores. Screening of depression in mothers was done using Symptom’s Checklist 90-Revised (SCL90-R) Depression dimension. Mini-Mental State Examination (MMSE) was used to assess maternal cognitive functions. Results Thirty-eight percent mothers of malnourished children were depressed compared with 12% mothers of healthy children. The difference was statistically significant (P<0.05). Statistically significant differences were found regarding maternal age at marriage, education, working status, crowding index, and family income between groups (P<0.01). Mothers of malnourished children had cognitive impairment than controls (P<0.001). The Z-score of malnourished children was positively correlated with breastfeeding duration, maternal age at marriage, education, working status, family income, and other social parameters; and negatively correlated with crowding index and gastrointestinal tract (GIT) morbidity, indicating that malnutrition increases with short duration of breastfeeding, younger maternal age at marriage, low education, bad working status, low income, and high crowding index. Conclusions Mothers of malnourished children have more depressive symptoms and impaired cognitive functions than the controls. Maternal age at marriage, education, family income, and crowding index are predictive variables affecting children nutrition.
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Predictors of coronavirus disease 2019 anxiety and coping among different age groups of Egyptian population p. 116
Omaima R.E Madkor, Dalia K Zayet, Dina H Abdelhady, Passant M AbdulJawad, Khalid E Elsorady
DOI:10.4103/ejpsy.ejpsy_1_22  
Objectives To determine predictors of anxiety and coping during coronavirus disease 2019 (COVID-19) pandemic among different age groups of Egyptian population. Patients and methods A cross-sectional study of 500 participants who completed an online questionnaire for anxiety and coping the following tools: COVID-19 Coping Responses Inventory, Coping Responses Inventory, COVID-19 Life Events−Anxiety Inventory, and the Arabic version of State-Trait Anxiety Inventory. Correlation between different variables, anxiety and coping related to COVID-19 was evaluated by Pearson’s correlation coefficient. Regression analysis was performed to evaluate predictors for anxiety and coping. Results COVID-19 Life Events (C-19L) is the most important in predicting COVID-19 related Anxiety (C-19A) as it has B value of 0.568 followed by level of education (B=0.217), and, monthly family income (B=0.140). Conclusion This study shows the impact of sociodemographic factors in predicting COVID-19 anxiety and coping among various sectors in the Egyptian community.
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CASE REPORT Top

Cerebral atrophy and cognitive impairment in a young patient with chronic cannabis use − a case report p. 122
Sripathi S Goud, Vishal Indla
DOI:10.4103/ejpsy.ejpsy_36_21  
Cannabis is known to mankind for ages. It was used as a medicine, an aphrodisiac, and a euphoriant. The psychotropic and neuromodulatory effects associated with cannabis use are extensively studied topics in the recent past. The authors report a case of cognitive impairment and cerebral atrophy in a young male patient with chronic cannabis use.
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