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Objectives This study aimed at estimating the prevalence of smoking in patients who were admitted to departments of neurology, chest, oncology, and general surgery of a general hospital in Cairo over a 6-month period. It also aimed at determining the relationship between smoking, stress, anxiety, depression, and personality characteristics in those patients. Patients and methods A selective sample comprising patients who were admitted to departments of neurology, chest, oncology, and general surgery of a general hospital in Cairo every Tuesday over a 6-month period was included in the study. The patients were fully conscious and cooperative; their ages ranged from 18 to 60 years. The patients were classified into four categories: current, past, passive, and nonsmokers. The Smoking Questionnaire, The Symptom Checklist-90-R, the Eysenck Personality Questionnaire, the Social Readjusting Rating Scale, the Beck Anxiety Scale, and the Beck Depression Inventory were used. Results Most of the patients (64%) were admitted to neurology or chest departments (32.7 and 31.3%, respectively). The smoking groups (current and past smokers) showed a male predominance (90 and 93.1%, respectively) in comparison with passive smokers and nonsmokers (60 and 61.3%, respectively). Most of the current smokers belonged to the 'mild anxiety' and 'severe anxiety' categories (70 and 26%, respectively). Among the past smokers, 58.6% had mild anxiety, 27.6% had severe anxiety, and 13.8% had low anxiety. Eighty percent of current smokers had mild and moderate depression (62 and 18%, respectively), and 69% of past smokers had mild and moderate depression (55.2 and 13.8%, respectively), with a high statistical significance (Po0.001). Most of the current smokers had mild or severe stress (54 and 28%, respectively), whereas most passive and nonsmokers had normal stress levels (55 and 61.3%, respectively). Current and passive smokers showed the highest mean levels on the symptom checklist (2.788±0.467 and 2.825±0.426, respectively). Similarly, the highest mean levels of psychoticism were reported among current smokers (18.78±3.259). The highest mean level of neuroticism was reported among current smokers (19.46±2.032). Conclusion Current smokers have higher anxiety, depression, stress, and psychoticism personality characteristics.

Background Drug abuse has been considered a male problem. Studies from several areas including epidemiology, behavioural pharmacology and neurosciences have taken a male-centric approach when analysing factors and/or treatments that influence drug abuse. This approach has led to a neglect of factors underlying drug abuse in women. Therefore, the extent and effects of drug abuse on women are not fully understood. Objective The aim of this study was to determine the prevalence of substance misuse and dependence among women residing in Cairo, Egypt. Participants and methods This is the fourth phase of the National Addiction Research Program. A total of 12 708 female residents from Cairo were interviewed in two waves: 2008 and 2009, according to a stratified sampling design. A specially designed questionnaire with questions derived from the Addiction Severity Index (ASI) was applied to all participants. Results A total of 3413 participants reported having tried smoking at least once in their life (26.8%), and 1802 participants reported using illicit substances at least once in their life (14.2%). Recreational and occasional patterns of substance use were reported by 2.5 and 2% of women, respectively, whereas regular use and abuse/dependence were more common (4.8 and 4.9%, respectively). Lower levels of education are related to higher prevalence of substance use, as well as higher prevalence of substance use in the separated, widow and divorced than single than married females. Women in the age range of 20-35 years had the highest rate of substance use. Cannabinoids were the most frequently used substances among the study sample (6.9%), followed by alcohol (3.8%) and opioids (2.7%). Conclusion The prevalence of substance use among women in Cairo is increasing (compared with a similar study published in 2009). The true prevalence of substance use in Cairo is probably higher than that reported, bearing in mind the extent of under-reporting. However, the extent of abuse/dependence detected in this study is unexpectedly high, probably because of sample composition and level of researcher training.

Background Patients suffering from major depressive disorder and different types of anxiety disorders sometimes present to nonpsychiatrists complaining of atypical presentations, for example, fatigue, which leads us to the question: does chronic fatigue represent another clinical presentation for depression and anxiety? Design and methods This study was a cross-sectional comparative study that included 100 adults presenting with fatigue without an evident medical cause and 50 controls presenting with fatigue associated with anemia to a general internal medicine outpatient clinic. All patients underwent a detailed clinical medical evaluation and were assessed by the Multidimensional Fatigue Inventory (MFI), the Mini International Neuropsychiatric Interview (MINI), the Hamilton Anxiety Rating Scale, and the Hamilton Depression Rating Scale. Results The most common primary psychiatric diagnoses of the 'nonorganic fatigue' group were depressive disorders (43%), somatization/hypochondriasis (31%), and anxiety disorders (27%). Physical fatigue, reduced activity, and mental fatigue were higher among the patients having organic fatigue than in those having nonorganic fatigue. The severity of depressive disorders was significantly correlated to reduced motivation and mental fatigue. Conclusion Fatigue is a presentation not uncommonly pointing to an underlying psychiatric condition. Sometimes psychiatric complaints cannot be expressed verbally by the patient although he is suffering from different psychiatric symptoms, usually those of depressive disorders.

Background Despite the advances in pharmacological treatment of schizophrenia, the results are unsatisfactory. Therefore, the search for new antipsychotic drugs and the development of novel treatments for schizophrenia are critical. Transcranial magnetic stimulation is one of the tools that may help schizophrenic patients. Aim of the study To evaluate the efficacy of repetitive transcranial magnetic stimulation (r-TMS) in the treatment of drug-resistant schizophrenic patients. Patients and methods This study included 40 drug-resistant schizophrenic patients. In a random, doubleblind placebo-controlled study, 30 patients were treated by 15 r-TMS sessions to both the left dorsolateral prefrontal cortex and the left temporoparietal cortex for 3 weeks. Ten patients were randomly subjected to sham stimulation (placebo group). Before and after the treatment sessions, all patients were assessed using the Positive and Negative Syndrome Scale, the Calgary Depression Scale for Schizophrenia, and cognitive tests. Results r-TMS could significantly improve only the negative symptoms. The positive symptoms, general psychopathology, and cognitive functions did not show any significant changes. The sham (placebo group) did not show any significant changes in schizophrenic symptoms and cognitive functions. Conclusion r-TMS can be a useful add-on treatment that helps to improve negative schizophrenic symptoms in drug-resistant patients.

Objective To assess coping strategies in a sample of risky suicidal Egyptian psychiatric outpatients. Participants and methods A total of 150 patients were selected from the psychiatry outpatient clinic; all patients were diagnosed according to the ICD-10 research diagnostic criteria. Patients were subjected to the Tool for the Assessment of Suicide Risk (TASR) and the Coping Inventory. Results The mean age of the patients with a high suicide risk was 35.5΁ 12.1; 40% had been diagnosed with an affective disorder, 27.3% with schizophrenia, schizotypal, and delusional disorders, 10.7% with other mental disorders because of brain damage, dysfunction, and physical disease, 8% with mental and behavioral disorders because of psychoactive substance use, 6% with neurotic, stress-related and somatoform disorders, 4.7% with disorders of adult personality and behavior, and 3.3% with other psychiatric disorders including organic mental disorders (dementia) and mild mental retardation. High and moderate risks of suicide were higher in men, 59.6 and 62.7%, respectively. Patients with scholastic education and unemployed patients were found to be significantly higher in both high and moderate suicide risk in comparison to patients with high education and employed patients, respectively. A statistically significant difference was found among single patients than separated, divorced, and widowed groups on moderate TASR. The diagnosis of affective disorders and schizophrenia, schizotypal, and delusional disorders was significantly higher on moderate and low TASR. Patients with a gradual/insidious onset scored significantly higher on all three groups of TASR. The mean duration of psychiatric disorders for a high suicide risk was 8.5 ΁ 8.16 years. Patients with a positive history of suicidal attempts and those who had made violent suicidal attempts scored significantly higher on both high and moderate suicide risk. Patients who had attempted one suicidal attempt scored significantly higher in high, moderate, and low TASR scores. Patients who used an active cognitive coping method scored significantly higher in high, moderate, and low suicide risk scores compared with the avoidance coping method. Conclusion The most frequently used coping method was active cognitive coping; also, patients showed a significantly higher suicide risk compared with the avoidance coping method. A cognitive positive understanding strategy (a subtype of active cognitive coping) scored significantly higher on high, moderate, and low suicide risk in comparison with passive resignation.

Background and purpose A strength training program was associated with changes in muscle strength, motor function, and proprioceptive position sense in a young child with poor body awareness and a diagnosis of developmental coordination disorder. Patients and methods This study included 80 children diagnosed with developmental coordination disorder. Their age ranged from 8 and 13 years. The children were divided randomly into two equal groups. The exercise group received a 3-month strength program that included upper limb, lower limb, and trunk and neck exercises as well as running three sessions per week The patients were evaluated and scored functionally, using the Behavior Rating Scale, and objectively, using a Biodex dynamometer, at different time intervals pretreatment and 3 months after the treatment program. Results The results showed a statistically significant improvement in the measured variables of both groups when comparing their pre-treatment and post-treatment mean values. A significant difference was found in favor of the study group (B) in comparison with group (A). Conclusion It can be concluded that a regular program of physical activities has a positive effect in improving the symptoms of developmental coordination disorder in children.

Background Subjective response of psychiatric patients to his/her medications is an important factor determining his/her compliance to treatment and hence the course of illness and prognosis. Objectives To explore the subjective experience of patients with psychotic and mood disorders with respect to their psychotropic medications and to investigate the probable role of different factors in shaping that experience. Participants and methods Eighty patients were selected to participate in this study (40 patients with psychotic disorders and another 40 with mood disorders). They were subjected to full history taking and psychiatric examination after taking their consent. The Drug Attitude Inventory (DAI 30) was then applied to reveal their subjective experiences with psychotropic medications. Results Employment and preserved insight were found to be associated with a positive subjective experience with psychotropic medications. A modest duration of current medication, a favorable side-effect profile of the administered drugs, therapeutic alliance with the treating psychiatrist, and associated psychotherapy with pharmacotherapy were all found to play a role in establishing a positive subjective experience with the prescribed drugs. Conclusion Certain factors are implicated in the determination of the subjective experiences of psychotic and mood disorder patients with respect to their medications. These factors should be carefully considered to increase patient compliance and improve the results and outcome of psychotropic medications.