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   Table of Contents - Current issue
January-April 2022
Volume 43 | Issue 1
Page Nos. 1-61

Online since Saturday, February 26, 2022

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Psychological crisis intervention protocol for isolated coronavirus disease 2019 patients p. 1
Mohamed R Soltan, Mariam E Dawoud
The WHO declared the current outbreak of coronavirus disease 2019 (COVID-19) a pandemic on March 11, 2020. The COVID-19 pandemic shook the entire world on January 2020 last year and is still posing a major threat to the entire humanity. In order to manage the urgent psychological need for support in response to the anticipated reaction of the population to the COVID-19 pandemic, the authors, who are members of Psychiatry Department, Fayoum University, Egypt, developed a new psychological crisis intervention model by implementing a psychological support system. The idea came to light at the time of the first wave of COVID-19 in Egypt, at the mid of May 2020 when the negative psychological impact of the virus was observed and constituted a great demand on the outcome of the virus. It will make a sound basis for developing a more effective psychological crisis intervention response system.
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Atypical antipsychotics in major depressive disorder p. 7
Hani H Dessoki, Mohamed R Soltan
The antipsychotics are used among pharmacological treatment of depression. Atypical antipsychotics have been used as monotherapy or adjunctively with antidepressants to treat depressive disorders with or without psychotic symptoms. The antidepressant effect of atypical antipsychotics involves regulation of monoamine, glutamate, gamma-aminobutyric acid, cortisol, and neurotrophic factors. To date, the United States Food and Drug Administration has approved aripiprazole and quetiapine slow-release tablets as adjunctive treatment for depressive disorders, and the combination of olanzapine and fluoxetine for the treatment of treatment-resistant depression. When using atypical antipsychotics in the treatment of depressed patients, clinicians need to monitor patients for the emergence of adverse effects, including hyperglycemia, weight gain, cholesterol levels, and extrapyramidal symptoms. These agents are effective for depression only at subantipsychotic doses. Receptor profiles predict that all second‐generation antipsychotics will have anxiolytic effects as subantipsychotic doses but that all will be dysphorogenic at full antipsychotic doses (i.e. produce a depression-like clinical picture). The antidepressant effect appears to be unique to some agents. Also, despite the availability of a large number of antidepressants of different classes, a significant portion of patients do not achieve remission, and treatment resistance is common. This paper reviews the antipsychotics that are effective for the treatment of depressive disorders, and the pharmacological mechanisms of antipsychotics in the treatment of depressive disorders.
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Short sensory profile and its relation with repetitive behavior and anxiety symptoms in children with autistic spectrum disorder p. 14
Heba E Abou El Wafa, Soha A El Latif Ghobashy, Amira K Zakaria
Background Sensory processing abnormalities have been reported in 42%–88% of children with autism. Atypical sensory features are thought to result from aberrant sensory processing, and may be evident across all sensory modalities, including auditory, tactile, vestibular, oral, olfactory, movement, and visual domains. Several studies have shown a high prevalence of anxiety in autistic children, although they have difficulties expressing their emotions. In this study, the relation between abnormal sensory profile, repetitive behavior, and anxiety symptoms in children with autism spectrum disorder (ASD) will be elucidated. Results Those with the definite difference in short sensory profile (SSP) represented 63.3% of the cases. As for the SSP domains, Under-responsiveness/Seeks sensation was the domain with the highest percentage of those with the definite difference (65%) followed by Auditory sensitivity (46.7%) and then Low energy (40%), whereas Visual/Auditory sensitivity was the domain with least cases showing definite difference (11.7%). Sensory abnormality is more evident in older children. Autism severity is related to the severity of the sensory abnormality. The total score of SSP showed a significant correlation with the total Repetitive Behavior Scale-Revised score. Anxiety Scale for Children with Autism Spectrum Disorder − Parent Version showed a significant correlation with the total score of SSP. Conclusion Sensory processing abnormalities are common among children with ASD and it is related to the severity of ASD, repetitive behaviors, and anxiety symptoms. Therefore, using these scales for individualization of the characteristics of sensory profile and their behavioral response and anxiety symptoms in basic assessment and follow-up is recommended, as well as promoting changes in therapeutic intervention through the possibility of choosing and designing the most appropriate intervention based on the individualized profile of the patients.
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Anxiety and depression regression and correlation as to rheumatoid arthritis patients’ clinical and sociodemographic characteristics p. 23
Samah Rabei, Hasan el Sonbaty
Background Studying anxiety and depression correlates to rheumatoid arthritis (RA) patients’ clinical and sociodemographic characteristics is rare in Egypt, so it is necessary to conduct this study. Results In total, 40 patients in rheumatology clinics of the Faculty of Medicine, Helwan University, assessed by International Classification of Diseases Version 10 symptom checklist and disease activity score 28, rendered a positive correlation between BMI and depression; regression of anxiety over the level of education; also regression of depression over the presence of comorbidity. Conclusion BMI, the presence of comorbidities, and level of education with RA relate to the presence of anxiety and depression in patients with RA.
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Anxiety and depression in addiction: magnitude of the problem p. 27
Hassan Sonbol
Aim Anxiety, depression, and substance-use disorders are common comorbidities in psychiatry and this is evidenced in the previous epidemiologic studies. The current study was conducted to evaluate anxiety and depressive symptoms among patients with substance-use disorder, also to detect the correlation between the degree of anxiety and depression on one hand and the sociodemographic variables and drug use-related problems on the other hand. Patients and methods A case–control study was carried out at Mansoura University Psychiatry Department (Addiction Unit), from December 2020 to the end of June 2021. A sample of 50 patients with substance-use disorder were included in the study according to the following criteria: (a) 18 years or older, (b) currently with the diagnosis of substance-use disorder according to Diagnostic and Statistical Manual of Mental Disorders-5, and (c) acceptance of the participation in the study, also with the following exclusion criteria: (a) the patient had known psychiatric diagnoses before being diagnosed with substance-use disorder, (b) the patient was intellectually disabled or has an organic brain disorder, and (c) the patient has chronic medical conditions. The control group of 50 individuals without a past or current history of substance-use disorder and free from chronic medical conditions as well. Results The present study was conducted on 50 age-matched and sex-matched groups, mean age of the studied groups is 29 (6.62) and 29.36 (6.56) for patients and control groups, respectively. Among the studied cases, 94% are polysubstance users, 90% have multiple routes for drug intake, 34.0% have peer pressure as the main reason for addiction, and 90% have started substance use from more than 1 year. Beck depression and Beck anxiety scores illustrate a statistically significant difference between the studied group with higher severity of depression and anxiety among the studied patients than the control group; moderate, severe, and extreme depression is detected among patients only and 32% of the patients’ group are suffering from mild anxiety, while 50% have moderate anxiety and severe anxiety was found among 18% of the studied cases. A statistically significant positive correlation is detected between Beck anxiety and drug-use identification test score (r=0.384, P=0.006). There is no statistically significant association between sociodemographic data and drug-use identification test among the studied cases (P>0.05). Conclusion Substance-use disorder is associated with depressive and anxiety symptoms of variable degree. There is a remarkable association between the presence of anxiety and depression on the one hand and the severity of drug-related problems on the other hand. Depression and anxiety are commonly present together in patients with substance-use disorders.
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Sociodemographic and substance characteristics among adolescents with psychotic disorders p. 34
Mostafa Aboeldahab, Salwa Tobar, Mohamed Elwasify
Background Over the preceding time, there is a significant bidirectional relationship between substance use and the development of psychiatric disorders during the adolescent stage. The comorbidity of substance use among adolescents with mental disorders is a major challengeable public health concern. This study examined the sociodemographic correlates and substance-use patterns among adolescents with psychotic disorders versus nonpsychotic psychiatric disorders (controls). Patients and methods This is a case–control study on 76 adolescents diagnosed with different psychotic disorders and another group of 76 adolescents with nonpsychotic psychiatric disorders using Mini-Plus International Neuropsychiatric Interview (MINI), Positive And Negative Syndrome Scale, and Alcohol, Smoking, Substance Involvement Screening Test and urine test. Results Substantial sociodemographic differences were found among the adolescents with psychotic disorders (case) (72.4% nonemployed, 71.1% rural areas, and 2.6% governmental healthcare services) compared with controls (60.5% nonemployed, 39.5% rural areas, and 28.9% governmental healthcare services), also, there was a significant difference in substance-use pattern among cases (lifelong use of tobacco 81.6%, cannabis 80.3%, and opioids 90.8%, with more substance-related problems) compared with controls (lifelong use of tobacco 61.8%, cannabis 55.3%, and opioids 73.7%, with less substance-related problems). Conclusion The sociodemographic variables related to rural residence, nonemployment, less approach to governmental health service, and positive family history of psychiatric disorders were the major contributing factors for psychotic disorders in adolescents with substance use. The lifetime use of cannabis and opioids was the major risk of developing psychosis among adolescents.
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Psychiatric comorbidities in adolescents with substance-use disorder p. 42
Hytham E El Badry, Magda T Fahmy, Ashraf M El Tantawy, Khalid A Anwar, Mona Elsayed
Introduction Comorbidity between substance abuse and other psychiatric disorders has been excessively documented in adults while rarely been investigated in adolescents. Aim The study investigated the prevalence of psychiatric comorbidities among adolescent patients with substance-use disorder attending psychiatric health facilities in Suez Canal region. Patients and methods It was a cross-sectional study conducted on 120 adolescent patients aged 13–19 with substance-use disorder attending psychiatric health facilities in Suez Canal region. Data were collected using comprehensive psychiatric history, Mini-International Neuropsychiatric Interview, complete physical and neurological examination, and urine toxicology screen. Results Most of the study-sample participants were polysubstance abusers (89.1%). Cannabis was the commonest substance abused (90.8%). More than half of the patients (53.3%) had psychiatric comorbidity with onset before the abuse of the substance, 27.5% had psychiatric comorbidity after abusing the substance, and 19.2% had no psychiatric comorbidity. Major depressive disorder was the most prevalent disorder (40.8%) among the patients, followed by conduct disorder (38.3%). Conclusion Depression and conduct disorder are the most common psychiatric disorders among adolescent patients with substance-use disorder.
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Vitamin D serum level and its correlation in obsessive–compulsive disorder p. 48
Mohamed Y Mohamed, Ahmed S Mohamed, Marwa A El Missiry, Mohamed Gamal
Background and aim Vitamin D has a long-known critical function in calcium metabolism and its role in proliferation, differentiation, and immunomodulation. A lot of studies report that low vitamin D serum level might be a risk factor contributing for the development of obsessive–compulsive disorder (OCD). The aim of this study was to evaluate the impact of sociodemographic factors on vitamin D and assess how prevalent is the hypovitaminosis D and its relation with OCD. Patients and methods In this study, data were collected from 50 participants of OCD males aged from 18 to 40 years. Vitamin D serum levels of participants in this study were measured using enzyme-linked immunosorbent assay kit. Results There is no significant relation regarding vitamin D level and OCD symptom severity found in our study. There is no statistically significant difference between participants of case group with low vitamin D levels (deficient and insufficient) in relation to OCD symptoms and severity. Conclusion There is a relation between low vitamin D serum level and OCD. However, there is no relation between vitamin D serum level, symptoms, or severity of OCD.
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Impact of coronavirus disease 2019 pandemic on parental stress and parenting practices during quarantine p. 53
Dalia Khalifa, Suzan Hagag, Walaa Fakher
Background Coronavirus disease 2019 (COVID-19) is a potentially fatal disease that is caused by SARS-COV2. Various types of stress have developed during the COVID-19 pandemic and have confronted many parents with challenging tasks. In aim of this study was to assess the parental stress during COVID-19 quarantine and its impact on the parenting practices during this critical period. Patients and methods This was a cross-sectional study in which 194 participants (parents of children aged 3–12 years) were recruited using a convenience and snowball sampling method through some Facebook and WhatsApp groups targeting parents with the required age. Cohen-Perceived Stress Scale Parenting practices during COVID-19-related questions were used to assess parenting stress and practices. Results More than two-thirds of participants were stressed (67%) according to the perceived stress scale. There was statistically significant difference between the age group of parents and perceived stress, P- value of 0.032. There was statistically significant difference between perceived stress and ways of punishment with a P value of 0.03. Majority of parents encouraged hobbies (71.1%) while less than half of the parents talked kindly with children, played with them, and described what happened to them (47.4, 41.8, and 46.4%, respectively). Conclusion Parental stress during quarantine is a significant risk factor on child abuse and maltreatment. It significantly affects the different domains of the parenting practices which consequently affect the child’s behavior.
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Later life depression as a risk factor for developing dementia: how much influence does the post-pandemic era have? p. 59
Lina S Arce, Andres F Ardila, Diana C Caicedo-Posso, Kelly N Molina-Perea, Ivan D Lozada-Martinez
By the year 2050, it is estimated that at least 20% of the world’s population will be over the age of 65. Depression in late life is a serious public health problem that has a negative and substantial impact on the quality of life of older adults, their families, and their social circle. Depression, in turn, constitutes a risk and prognostic factor for the development or worsening of dementia, a condition present in about 10% of the population over 60 years of age, and which increases and intensifies with age, being up to 40% at age 90. In the context of the current COVID-19 pandemic, aspects such as persistent isolation and loneliness, socioeconomic distress, lack of family and professional support, fear of illness and death, are potential negative risk factors for developing depression and worsening the prognosis of dementia in older adults.
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