Background The magnitude of the problem of substance use in Egypt has been growing lately. Substance use disorders (SUDs) have been associated with depression and suicide, as well as impulsivity and specific personality traits. Aim and Objectives This study aimed at evaluating suicide risk and its correlates in a sample of 40 substance users and 40 control subjects. Methods The severity of the addiction problem among substance users was assessed using Addiction Severity Index (ASI). Beck Suicide Inventory (BSI), DSM-5 Brief Personality Inventory (PID-5 BF) and Barrat’s Impulsivity Scale-11 were applied to both groups. Results The study showed that patients with SUDs had a higher suicide risk when compared with controls (P<0.05). They also showed higher impulsivity scores (P<0.05) and personality trait disorders (P<0.001) when compared with controls, particularly in antagonism (P<0.001), disinhibition (P<0.001), negative affect (P<0.05) and psychoticism (P<0.05). Conclusions Pathological personality traits may be associated with increased risk of suicide in patients with SUDs.

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Background Psychoeducation is an evidence-based therapeutic intervention for patients and their families that provides information and support to better understand and cope with illness. Aim The aim of this study was to assess the effectiveness of patient and caregiver schizophrenia psychoeducation program and its impact on improvement of psychopathology and quality of life (QoL). Patients and methods This study was carried out on 116 consented schizophrenic patients and their primary caregivers. Severity of the symptoms was rated using Positive and Negative Syndrome Scale. QoL was measured using World Health Organization Quality of Life Questionnaire-short version (WHOQoL-BREF) scale. Results There is a statistically significant difference between patients who received psychoeducation and those treated as usual regarding question 1, question 2, domain 1 (physical), domain 2 (psychological), domain 3 (social relation), and domain 4 (environment) measured by WHOQoL scale with higher score in received psychoeducation patients. Conclusion Psychoeducation should be considered as an important intervention for the management of schizophrenic patients as it improves their QoL and supports the caregiver.

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Background Smoking is highly prevalent in bipolar patients. In addition, cognitive dysfunctions are reported in most of the bipolar patients even in remission state. Does this mean that smoking can affect cognition in bipolar patients similar to what is hypothesized in schizophrenic patients? Objective The objective of this research was to study the correlation between smoking and cognitive dysfunction in bipolar patients. Participants and methods A total of 150 bipolar patients (50 manic, 50 depressed, and 50 euthymic) in Maamoura Hospital were compared with 50 controls regarding smoking, Hamilton Depression Rating Scale, Young Mania Rating Scale, and cognitive functions using Wisconsin Card Sorting Test and digit span test and digit symbol test. Results The percentage of smoking was significantly higher in all patients’ groups compared with the control group. No statistically significant relations were found between performance on the Wisconsin Card Sorting Test-128, digit span neither forward nor backward digit span subtest of the Wechsler Adult Intelligence Scale − Revised (WAIS-R), the digit symbol substitution test (the digit symbol subtest of the WAIS-R) and smoking in manic, depressed, and control groups. A statistically significant positive relation was found between performance of the euthymic patients in forward digit span subtest of the WAIS-R and smoking. Conclusion Smoking may have a positive effect on sustained attention of bipolar patients during euthymic state, but not in active illness state. Further research is needed to disclose how we can exploit the beneficial cognitive effect of nicotine by avoiding the deleterious effect of tobacco smoking.

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Background Medical education is perceived as being stressful, with negative effects on students’ mental health. Therefore, the aim of this study was to assess psychiatric morbidity among final year medical students from the Faculty of Medicine, Cairo University. Participants and methods A total of 200 students were randomly chosen during attendance of their psychiatry round. Both male and female students were included in the study, and students with major medical diseases were excluded. All participants signed an informed written consent. Participants were subject to clinical assessment using the semistructured interview of Present State Examination (PSE). Data were transferred to the statistical package of social science version 20 for quantitative data analysis. Results Overall, 61% of the students were males and 39% were females, and the age of both male and female students ranged from 21 to 31 years old, with a mean value of 23.21±1.09 years. None of the students in the sample were diagnosed as having any of the psychotic disorders. Overall, 83 and 44% of students in the sample had subclinical mood and anxiety symptoms, respectively. Conclusion Most students had anxiety and depressive symptoms not mounting to a diagnosis, and a substantial proportion of medical students had an ongoing psychiatric condition.

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Background Comorbidity of bipolar disorder (BD) in obsessive–compulsive disorder (OCD) patients is a relevant phenomenon and has significant effect on expression of symptom, treatment, and complications of the disorder. Objective The aim of this study was to find the frequency of BP in patients with OCD, determine the effect of BP occurrence on the clinical characteristics of OCD, and compare between OCD patients with and those without BP. Patients and methods Sixty individuals with OCD diagnosed according to the Diagnostic and statistical manual for mental disorders, 5th ed., were subjected to screening using the Obsessive–Compulsive Symptoms Scale, the Yale–Brown Obsessive–Compulsive Scale, the Hamilton Depression Rating Scale, and Mood Disorder Questionnaire. Results Fifteen percent of the OCD patients included in the study had additional lifetime diagnosis of BD. There was a statistically significant relation between comorbidity and episodic course of OCD, previous psychiatric hospitalization, and suicidal attempts. Patients with comorbid BD comprised mainly male patients and urban residents with a high incidence of religious obsessions and compulsions, general compulsions (e.g. checking, ordering, and arranging), and repetition, but with no statistically significant difference. Conclusion A better understanding of the clinical profile of individuals with a primary diagnosis of OCD with and those without BD helps in guiding the treatment of individuals.

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Objective The purpose of this article is to study dissociative symptoms in female addicts exposed to sexual abuse in their childhood. Participants and methods This study included 44 Egyptian females who were recruited from a private psychiatric hospital and from a halfway center receiving treatment for substance abuse. Overall, 22 cases were sexually abused during their childhood (before age of 18 years), whereas 22 controls were not exposed to sexual abuse. Addiction severity index was used to assess history of addiction, age of starting smoking, and age of starting substance abuse. Addiction severity index was used to measure emotional abuse and physical abuse. Sexual abuse questionnaire was used to measure sexual abuse. Questionnaire of experience of dissociation was used to measure dissociative phenomena. Results There was a statistically significant difference regarding the age of starting smoking (P=0.03) and age of starting substance abuse (P=0.04). Moreover, there was a highly statistically significant difference between both groups regarding questionnaire of experience of dissociation scores (P=0.00). Conclusion Female participants with substance dependence who are sexually abused showed more pathological dissociative symptoms than those who were not. Female participants who are sexually abused during their childhood are more prone to start smoking and substance abuse at younger age than their peers. Physical abuse was higher in sexually abused female participants than those who were not.

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Background Depressive episodes are present in both bipolar disorder (BD) and major depressive disorder (MDD). Do cognitive dysfunction symptoms of depressive episode differ according to the disorder (MDD or BD)? Aim of the work This work aimed to study the cognitive functions among patients with BD (depressive or mixed) and MDD during relapse. Patients and methods This study included 90 patients during relapse diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision (DSM-IV-TR) (30 bipolar mixed, 30 bipolar depression, and 30 major depression) and 30 control participants. They were compared in terms of the severity of depression (using the Hamilton Depression Rating Scale), working memory (using the digit span test), processing speed (using the digit symbol test and trail making test A), verbal fluency (using the verbal fluency test), and executive function (using trail making test B). Results The scores of BD patients were significantly worse than those of MDD patients in digit span tests (forward and backward), digit symbol test, verbal fluency test, and trail making tests (A and B). No significant difference was found between bipolar depression patients and bipolar mixed patients in the patterns of cognitive dysfunctions and the severity of cognitive dysfunctions. Conclusion Bipolar patients experience significantly greater impairment than major depression patients. Other differentiators between the two disorders were that BD have lower age of illness onset, higher number of previous episodes, higher numbers of previous hospitalizations, and greater presence of psychotic features than MDD.

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Background The role of inflammation has received increasing attention as a potential pathophysiological mechanism in bipolar disorder (BD). Objective To compare the level of soluble tumor necrosis factor-α receptor 1 (sTNFR1) in manic state of BD with healthy controls and investigate the relation between its level and the severity of BD. Patients and methods Serum levels of sTNFR1 were measured with enzyme-linked immunosorbent assay techniques in 44 patients with BD-I during the manic episode and 88 healthy controls recruited from Kasr Al Ainy Hospital, Cairo University. The severity of the manic symptoms was assessed using Young Mania Rating Scale. Results The level of sTNFR1 was higher in patients with BD-I, with the most recent episode manic, than in healthy control. Patients with BD-I, with the most recent episode manic, with psychotic features had higher levels of sTNFR1 than those without psychotic features. sTNFR1 level correlated with Young Mania Rating Scale scores. Conclusion High level of sTNFR1 may be considered as state marker in manic episodes in patients with BD-I. The more severe the disease, the higher the level of sTNFR1.

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