Background Domestic violence against women is prevalent in every country, cutting across boundaries of culture, class, education, income, ethnicity, and age. Domestic violence against women results in far-reaching physically and psychological consequences. Although the impact of physical abuse may be more visible, psychological scarring is harder to define and report. Women who remained in violent relationships were considered to have morbid characteristics, which included the need to be hurt and punished. Objective This work was carried out to determine the psychosocial characteristics of women exposed to domestic violence. Materials and methods The current study is a cross-sectional controlled study. In this study, psychological characteristics, using the Minnesota multiphasic personality inventory scale (MMPI) personality inventory scale, of 44 women (who presented to the Emergency Unit of Suez Canal University Hospital) complaining of physical abuse of domestic origin were evaluated after taking their consent, and were compared with 22 women with no history of domestic violence. Results The psychological assessment to 44 female victims of domestic violence according to the MMPI personality inventory scale showed a significant difference between the study and the control group in depressive traits, psychopath traits, and psychotic traits. Conclusion Our finding suggested that the study group showed more depressive, psychotic, and psychopathic manifestations than the control group and more studies need to identify whether this results were related to abuse or character logical traits in those women.

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Background School aggression has become an increasing concern to public health professionals, clinicians, policy makers, educators, and the general public. It is a multifaceted problem with biological, psychological, social, and environmental roots. Aim The aim of this study was to examine the prevalence and the influence of social, family, and school environments on the development of school aggression. Patients and methods A multistage stratified sample of 574 students of both sexes aged 13–18 years was selected from the preparatory and secondary schools chosen from Zagazig Center through the academic year 2014–2015. Sociodemographic characteristics of the students were evaluated using a self-reporting questionnaire. Aggressive behavior was assessed using the Aggressive behavior and hostility scale for adolescents (the parts of physical and verbal aggression). Results Physical aggression was severe in 0.7% of the sample, moderate in 8.5%, mild in 39.2%, and minimal in 51.7%. As regards verbal aggression, it was severe in 0.5% of the sample, moderate in 8.0%, mild in 40.5%, and minimal in 51.1% of the sample. Risk factors for aggression were male sex, age greater than 15 years, unfavorable school atmosphere, practicing sports, smoking, watching action movies, personal history of physical abuse, being second-born child of the family, attending urban schools, and a history of dropping class. Conclusion School aggression is a frequent and a serious problem among school adolescents. It is necessary to evaluate the level of seriousness and attempt to find effective preventing measures.

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Introduction The 20th century ended with the conviction that drug abuse was a global problem and thus global solutions were required. This is a cross-sectional study that was carried out in Zagazig Center, Sharkia governorate, in the year of 2013 (September to October). Participants and methods The study included 204 preparatory and secondary school students. The mean age of the participants was15.26 ± 1.59 years. The school students were met in their classrooms, in the presence of their teachers, and assessed for substance abuse using the Drug Use Disorders Identification Test (DUDIT) and the Drug Use Disorders Identification Test-Extended (DUDIT-E); urine samples were then collected for all participants during the interviews using the multidrug one-step test. Results The prevalence of smoking and substance abuse among school students were 8.3 and 8.8%, respectively, and the majority of them used substances once a month or less. The most common substances used by the students included tramadol, cannabis, and alcohol (83.3, 27.8, and 16.7%, respectively), with a mean age of onset of smoking of 16.06 ± 1.39 years and a mean age of onset of substance abuse of 16.5 ± 1.098 years. Conclusion Substance abuse and smoking were common among adolescents, and the age at onset was almost the same for both. DUDIT and DUDIT-E may significantly contribute to more effective screening of drug problems in research and clinical settings with groups at risk and it may be useful for mapping drug use among different groups in public health contexts.

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Background

Schizophrenia is a chronic disease of the body and mind that affects 1% of the population. About one-fifth to one-third of all patients with schizophrenia do not respond adequately to drug treatment and that have been consistent over time. Definitions of this group have long been hampered by a lack of consistency with confusion with chronicity. Clozapine has shown superior efficacy and this has been replicated consistently.

Aim and objectives

Because of the high prevalence, importance, and inconsistency of schizophrenia resistance, the current study aimed to (a) examine the differences between resistant and nonresistant schizophrenic groups in chronic long-stay patients, (b) study the clinical profile of the clozapine-resistant group in comparison with others, and finally (c) determine the predictors of resistant schizophrenia.

Methods

This was a retrospective and cross-sectional study of 95 patients with chronic schizophrenia or schizoaffective disorder, admitted in long-stay hospital wards at the Psychological Medicine Hospital (Kuwait). They were interviewed by Structured Clinical Interview for DSM-IV and diagnosed according to the Diagnostic and Statistical Manual of Mental Illness, 4th ed. criteria. Patients were assessed by the Brief Psychiatric Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression Severity (CGIS) scale, and Mini-Mental State Examination. Sociodemographics, clinical characteristics, and the history of treatment were determined. Schizophrenia resistance was formulated according to modified Kane’s criteria, which include the following: BPRS score of at least 45; two or more of positive symptoms score of at least 4 (suspiciousness, hallucinatory behavior, conceptual disorganization, and unusual thoughts); CGIS score of at least 4 (moderate to extremely ill); previous failure on two antipsychotic trials of different categories of the full therapeutic range (≥1000 mg of chlorpromazine equivalent) and for at least 3–6 months’ duration; and finally, no preceding good function for at least 2.5 years in the last 5 years.

Results

Thirty-six patients fulfilled the criteria of schizophrenia resistance (37.8%). There was a significant shift in the drug regimen prescribed, with the prescription of more atypical antipsychotics, especially clozapine, with repeated failure of previous drug trials. The only significant difference between the resistant and the nonresistant group was in the psychopathological severity, indicated by higher scores on PANSS, and CGIS scores. Age younger than 40 years and early onset age of schizophrenia (<20 years) were powerful predictors for schizophrenia resistance; other sociodemographic and clinical characteristics lacked significant predictive value.

Conclusion and recommendation

Younger age and early-onset schizophrenia are considered poor prognostic factors. Early aggressive management of schizophrenia may help eliminate chronicity as well as resistance. Research on the biological predisposition for schizophrenia resistance including the clozapine resistance group is required.

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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 Child abuse − a form of family violence − is one of the major public health issues with far-reaching effects and costs and have many implications on health policy and prevention strategies. Objective The aim of the study was to assess risk factors of child physical abuse among school-aged children in the child’s background and family characteristics and to estimate its psychiatric sequelae. Patients and methods The study was conducted in Maternity and Children Hospital, Al Medina (Al Monawara), Kingdom of Saudi Arabia, on school-aged children referred from the committee protection program from September 2012 to April 2015 using such some psychometric tests as the Child Maltreatment Questionnaire, the Mini International Neuropsychiatric Interview for children and adolescents (for major depressive episodes), Revised Behavior Problem Checklist, and Copper Smith Self-Esteem Inventory. Results Out of 186 students (age range between 12 and 16 years) 49.4% were the youngest children, mainly boys (58%), 94% had good health, 70% were from large-sized families, and 51% of whose mothers and 54% of fathers were illiterate, and all these variables showed a significant difference in both mild/moderate and severe child abuse. There were significant associations between physical abuse and low self-esteem, major depressive episode, conduct disorder, anxiety withdrawal, attention deficit hyperactivity disorder, and socialized aggression, mainly with severe physical abuse. Conclusion Physical abuse is found in a significant proportion of children, mostly living in large-sized families, of illiterate unemployed parents. Furthermore, physical abuse is commonly associated with low self-esteem, major depression episodes, conduct disorder, attention deficit hyperactivity disorder, and socialized aggression.

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Introduction Obesity is actually conceptualized as a complex, multifactorial disorder, in which genetic, psychological, physiological, environmental, and socioeconomic factors play a major role. The nature of the relationship between obesity and psychological distress continues to be debated by researchers and clinicians. Some studies have suggested a relationship between being overweight and having increased psychiatric symptoms, and an association between obesity and several lifetime psychiatric disorders, whereas other studies have found no association at all. Aim It is hypothesized that there are differences between obese and normal-weight women in different dynamic aspects; therefore, here, we compare them in terms of defense mechanisms, self-esteem, and body image. Also, we attempt to explore the association between the degree of obesity and the severity of psychopathology. Patients and methods This was a case-control cross-sectional study, in which a group of 40 obese women seeking treatment for obesity were recruited from the National Nutrition Institute (BMI ≥ 30), and a group of 40 healthy normal-weight women were recruited from among the general population (control sample). They were subjected to the following psychometric procedures: Symptom Check List-90-R (SCL-90-R), Body Image Questionnaire (BIQ), Rosenberg Self-Esteem Scale (RSES), and Defense Style Questionnaire (DSQ-40). Results In terms of SCL-90-R, there was a significant difference between the two groups in the somatization, hostility, and paranoid ideation subscales; the scores for these on SCL-90-R were higher in the obese group. For BIQ, there was a statistically highly significant difference between the two groups; obese individuals had a disturbed body image compared with those in the control group. For DSQ-40, the obese women showed excessive use of immature defenses (displacement) and the control group showed frequent usage of neurotic defenses (reaction formation); there was a significant difference between the two groups in the two defenses. There was no significant difference in self-esteem. There was a positive correlation between BMI and the somatization subscale, BMI and the phobia subscale, and BMI and the Global Severity Index subscale of SCL-90-R in the obese group. There was a positive correlation between BMI and the depression subscale and BMI and the interpersonal sensitivity subscale of SCL-90-R in the control group. There was a negative correlation between BMI and mature defense styles in the obese group, whereas in the control group, there was a positive correlation between BMI and immature defense styles. There were no significant correlations between BMI and both BIQ and RSES. Conclusion Obese women have more disturbed body image, immature defense mechanisms, and psychopathology than the control group.

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Background One of the major consequences of substance misuse is its effect on patient cognition. Pregabalin is a new-generation antiepileptic which is believed to have an addictive effect. Objective This cross-sectional study is aimed to estimate the prevalence of cognition impairment among patients with pregabalin misuse. This study includes 300 patients and 100 controls with matched age, sex, and education. The drug abuse patients were divided into two groups: the first group patients used pregabalin alone and the second was a polysubstance group; each group was formed of 150 patients matched in sex, age, and educational level to the pregabalin group. For the diagnosis we used urine screening for drugs. We used the Montreal cognitive assessment test in Arabic edition to evaluate the cognitive function of the patient. Result Cognitive impairment was more in pregabalin misuse patients (M=25.4, SD=3.3) than in the control group (M=27.5, SD=3.7) according to the Montreal cognitive assessment test, P value less than 0.001. The most affected domains were visuoconstruction, digit span, verbal fluency, and recall, with dose (M=625, SD=400). There was no association between cognitive impairment and dose of pregabalin or duration of substance abuse. Conclusion This study concluded that pregabalin misuse patients were likely to have cognitive impairment due to the drug effect and their cognitive impairment was less than the polysubstance misuse group.

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Background Maternal depressive and anxiety symptoms during pregnancy have been reported in some, but not all, studies to be associated with an increased risk of preterm birth and intrauterine growth restriction (IUGR). Objectives The aim of this study was to estimate the risk of preterm birth and IUGR associated with antenatal anxiety and depression during early pregnancy and to evaluate their impact on fetal growth and the birth outcome. Patients and methods The following measures were applied to 54 pregnant mothers: the Edinburgh Postnatal Depressive Scale (EPDS), the Beck Anxiety Inventory (BAI), and fetal biometric data and behavior were recorded during ultrasound examination at 24-36 weeks of gestation and the placental blood perfusion was measured by Doppler assessment of the systolic/diastolic ratio (S/D ratio) of the umbilical artery in the third trimester. Results This study revealed that women with depressive and anxiety symptoms in the third trimester of pregnancy exhibit an increased likelihood of having oligohydramnios, IUGR, diminished placental perfusion, and preterm labor. Conclusion This study provides evidence that maternal depressive and anxiety symptoms during pregnancy are associated with various fetal developmental problems.

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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 Autism spectrum disorders (ASDs) represent a group of neurodevelopmental disorders characterized by impaired reciprocal socialization and communication, often accompanied with stereotyped ritualistic behavior. To date, no clear data could explain the dramatic worldwide increase in the incidence of ASD during the last two decades. It is suggested that some environmental factors besides a genetic predisposition leads to the disease. In addition, the disease is known to be associated with other psychiatric comorbidities. Aim The current study aimed to assess the incidence of psychiatric comorbidity present in those children and to relate the findings to the severity of the disease. Patients and methods The current study included 40 children (27 boys and 13 girls), with ages ranging from 3 to 11 years, and diagnosed with ASDs on the basis of the DSM-IV-TR criteria. Patients were divided to three groups according to their score on Gilliam Autism Rating Scale: mild ASD (10 cases); moderate ASD (11 cases), and severe ASD (19 cases). Data were collected through clinical psychiatric interview, Mini International Neuropsychiatric Interview for children and adolescent (M.I.N.I. KID), the Gilliam Autism Rating Scale, Vineland Adaptive Behavior Scales, and a scale for measuring family socioeconomic status for health research in Egypt. Results The present study demonstrated that 72.5% of the cases presented in families with middle socioeconomic status, which are highly educated, the majority (80%) of parents of studied cases lacked consanguinity degree, while only 20% from them had consanguinity from first degree; the vast majorities (92.5%) of the cases were not presented with family history of autism. As regards comorbidity, 90% of the cases were associated with one or more comorbid conditions and the presence of more than one comorbidity usually associated with male sex and severe type of autism, 72.5% of studied cases suffered from comorbid tics (40% occurs in severe autism), 25% of cases presented with associated attention-deficit/hyperactivity disorder, 20% of cases suffered from oppositional defiant disorder (ODD) as comorbid conditions, 37.5% of studied cases had comorbid obsessive compulsive disorder (OCD), and 5% of cases suffered from comorbid general anxiety disorder. Conclusion From the current study it was concluded that boys, high and moderate socioeconomic states, consanguinity, positive family history represented conditions that are associated with an increased risk for autism and ASDs in Egyptian population. Presence of one or more of those risk factors in children with autism is usually associated with severe type of the disease and more associated comorbidities. Determining the contribution of these risk factors may improve detection, earlier treatment, and better prevention of the disease. Comorbid tics, attention-deficit/hyperactivity disorder, ODD, and OCD are most presented among boys, whereas comorbid general anxiety disorder is more presented in girls with autism. The most occurring coincidence of comorbidity is comorbid tics and OCD, followed by comorbid OCD and ODD. Those coincidences were associated with severe autism and male sex. We suggest future studies using large samples to confirm the finding of the present work.

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Background Culture plays a major role in healthcare delivery. The majority of mentally ill patients prefer to attend nonmedical practitioners such as traditional healers. Practical clinical application of the research in cultural competency can enable physicians to decide whether folk traditional healing practices are harmful or benign. Like other cultures, the Arab culture transmits a number of beliefs, which are locally shared, although considered unlikely or even objectively disprovable by others outside the culture. Aim In this paper, we examine the view of mood disorders as seen by the patients and the role of faith healers in the treatment of such disorders with regard to urban versus rural areas. Patients and methods We assessed 416 United Arab Emirates national patients with Bipolar Affective Disorder (BAD) (279 urban and 137 rural) after confirmation of diagnosis with Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revised. These patients underwent Mini International Neuropsychiatric Interview, Help-Seeking Pattern, and Experience Questionnaire, which stressed on the attitude of the patient toward psychiatric illness, belief in healer management, line and result of traditional management, and the frequency of seeking traditional healers. Results The current study showed that about 60% of patients of both populations had visited faith healers before seeking medical services. Rural population usually shows no commitment to treatment and resorts to traditional therapy more often compared with the urban population (24 vs. 17.5% and 33.7 vs. 19%, respectively). Rural patients were more credulous toward faith management compared with urban patients (35.1 and 18.4%, respectively), whereas a merge of the two beliefs, psychiatric and faith management, was more common in the urban population than in the rural population (31.6% compared with 9.6%, respectively). An overall 39.5% of the families of urban cases and 9.6% of the families of rural cases considered mental illness a real disease as any other organic disease. In faith healing, different diagnoses, which included touch, evil eye, witchcraft, and jinn possession, were evenly distributed among patients with varying percentages among rural and urban populations. Conclusion This study shows that the majority of patients suffering from mental illness, especially in rural populations, prefer to approach faith healers first, which may delay entry to psychiatric care and thereby negatively impact the prognosis of BAD. Therefore, we should improve the orientation of the general practitioners (GPs) and broaden the destigmatization program about psychiatric disorders, especially mood disorders. This highlights the importance of mental health education, developing a positive collaborative relationship with traditional healers, and highlighting the role of cultural beliefs in both the evaluation and the management of mental disorders.

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Introduction Studies have proposed that cognitive deficits are present in a variety of mood states in bipolar disorder (BD). In addition, a few studies have pointed to the presence of sex-related differences in cognitive dysfunction in BD. Aim of the work This comparative study aimed to study the cognitive functioning of BD patients in different episodes, and detect any sex-related differences in cognitive functioning in the studied sample. Patients and methods The recruited sample consisted of 150 patients selected at random from El Maamoura Mental Hospital over 6 months. Four groups were formed: group I, comprising 38 (19 male and 19 female) BD patients having manic episodes; group II, comprising 26 (12 male and 14 female) BD patients having depressive episodes; group III, comprising 36 (20 male and 16 female) patients in remission (euthymic); and group IV, comprising 50 controls matched for age, sex, and education. Clinical and psychiatric evaluations were carried out and psychometric assessment was performed using the 17-item Hamilton Depressive Scale and the Young Mania Rating Scale, as well as cognitive assessments using three tests: Wisconsin's Card Sorting Test (WCST), the digit span subtest of the WAIS-R and DSST (the digit symbol subtest of the WAIS-R). Results The BD patients in the three groups having BD showed significant cognitive deficits compared with controls. Manic and depressive patients showed impairment in attention, working memory, and executive functions. Euthymic patients showed significant impairment in working memory and executive functions. Only euthymic patients revealed a statistically significant sex-related difference in terms of short-term memory, attention, and working memory, with women being worse than men. Interestingly, in the control group a difference in executive functions was reported wherein healthy control women performed significantly better than control men on the WCST-128 (completed significantly more number of categories and committed significantly fewer perseverative errors). Conclusion Cognitive dysfunction should be regarded as a core feature of BD as it was present across all mood states in our sample. In addition, discrepancy has been found between male and female euthymic patients regarding cognitive functions, suggesting a sex-related difference in the clinical expression of BD.

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Aim Studying the cognitive functions among Alexandria University Students Hospital patients, suffering from common migraine (either newly diagnosed or on regular treatment). Patients and methods A total of three groups were studied: the newly diagnosed migraine group (group I, 20 patients), the chronic migraine group (group II, 20 patients), and the control group (group III, 20 patients). Their cognitive functions were compared using Wechsler Adult Intelligence Scale. Results The mean total intelligence quotient (IQ) scores of chronic migraine group (106.65±4.18) and newly diagnosed migraine group (106.90±4.95) were significantly lower than that of control group (111.35±6.47) (P=0.007). There was no significant difference between mean IQ scores of chronic and newly diagnosed migraine groups. The mean score of newly diagnosed migraine (6.80±1.54) in digit backward subtest was significantly higher than that of chronic migraine group (5.70±1.49) and control group (5.70±2.13) (P<0.05). Conclusion Patients with migraine have worse score than control in total IQ. However, this score is still within the normal limits. This difference may be related to the pain itself. This needs to be scientifically tested in further researches. On the contrary, newly diagnosed migraine group showed worse performance in working memory than chronic migraine group. No difference between chronic migraine patients and control. This denotes that adaptation can improve working memory of patients with migraine with the passage of time.

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Background This work was conducted to test for the association of genetic polymorphisms of catechol-O-methyltransferase (COMT) with the susceptibility and clinical patterns of schizophrenia among Saudi patients. Participants and methods This is a case-control study involving 79 patients fulfilling the ICD-10 criteria of schizophrenia and 82 healthy controls. Patients were interviewed by different tools, which included the Diagnostic Interview for Genetic Studies (DIGS/V4.0), the Positive and Negative Symptoms Scale (PANSS), and the World Health Organization Disability Assessment Schedule (version 2.0) (WHO/DAS II). All patients and controls were screened for COMT G >A gene polymorphisms using the real-time PCR technique. Results Frequencies of all genetic variants of COMT G >A [V158M] did not show a significant difference on comparing cases with controls (P > 0.05). Comparing the frequencies of genetic variants in cases having positive parental consanguinity and a family history of schizophrenia or other mental illnesses with those without a history also showed nonsignificant results (P > 0.05). A stratified analysis related to severity scores and associated clinical illnesses also showed a nonsignificant difference (P > 0.05). Conclusion Polymorphism related to COMT G >A was not associated with the susceptibility and the severity of schizophrenia among Saudi cases.

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Background The outcome of childhood-onset schizophrenia (COS) is generally regarded as poor. Few prospective studies have been reported from developing countries. Aim The aim of the present study was to assess the functional outcome in COS and the factors associated with poor outcome. Methods This 3-year prospective study included 19 patients with COS. Diagnosis was based on the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., criteria using the Kiddie-Schedule for Affective Disorders and Schizophrenia − Present and Lifetime Version; severity was assessed through the Positive and Negative Symptoms Scale, whereas the measure of outcome used was Children’s Global Assessment Scale. Results The mean duration of follow-up was 39.53 (SD ±5.37) months. The mean age of onset of COS was 10.47 (SD ±0.91) years. At the end of the study, 31.6% of the participants had good outcome, 42.1% had moderate outcome, and 26.3% had poor outcome. Factors associated with poor outcome included history of perinatal complication, more negative symptoms, and longer duration of untreated psychosis. Conclusion More than a third of the sample showed good outcome over the few years of follow-up. On the basis of the findings of this study, we recommend an early intervention.

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Background The relationship between mental health and obesity has been studied in different types of research studies as it is considered very important. A lot of research studies have proposed several theories and mechanisms on how the two are linked, which should be reviewed and considered in the management plan of psychiatric disorders. Objectives The aim of this study was to find out the prevalence and correlates of obesity and overweight in a sample of psychiatric patients (inpatients and outpatients) with no history of pharmacological treatment in Al-Hussein University Hospital. Patients and methods This cross-sectional study was conducted during a 6-month-period on 130 psychiatric patients who were subjected to a semistructured clinical interview according to DSM-IV-TR criteria to diagnose psychiatric disorders. Obesity assessment was carried out by measuring the weight (kg) using a scale and measuring the height (m) to calculate the BMI, which is based on the BMI equation Wt (kg)/Ht² (m²). Results The prevalence of obesity and overweight in psychiatric patients was 66.93% (22.31% were obese, and 44.62% were overweight). The prevalence of obesity was highest in bipolar disorder (41.38%), followed by depression (37.93%), schizophrenia (10.34%), anxiety disorder (6.9%), and finally substance abuse disorder (3.45%), but the difference was not statistically significant. There was a significant correlation between sociodemographic characteristics of patients and obesity and the distribution of psychiatric disorders. Conclusion The prevalence of obesity and overweight in psychiatric patients was relatively high, and this can occur with most psychiatric disorders, especially mood disorders, and were supposed to be due to other several mechanisms and risk factors other than the effect of psychotropic medications on the weight of psychiatric patients. Moreover, there are some demographic and social factors that may moderate or mediate the association between obesity and psychiatric disorders; thus, identification of overweight and obesity, associated risk factors, and efforts to prevent weight gain should begin at the initiation of mental health treatment.

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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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Introduction Attention-deficit hyperactivity disorder (ADHD) is considered to have a biologic basis, but the precise cause is unknown. It is one of the neurodevelopmental abnormalities observed frequently in children with generalized resistance to thyroid hormone, suggesting that thyroid abnormalities may be related to ADHD. Aim To assess thyroid dysfunction in children with ADHD and to detect the most common comorbidity. Participants and methods This was a case-control cross sectional study, in which 30 ADHD children were recruited from the Kasr Aini Pediatric Hospital (Abu-El Rish) outpatient psychiatry clinic and compared with 14 healthy control children, siblings of the patient group who participated in this research. Psychometric procedure The Stanford Binet Intelligence Scale, the Arabic version of Conners' Parent Rating Scale-Revised-Long version, and social score were used to calculate social standards of families. Laboratories assessment Serum total T3, total T4, and thyroid-stimulating hormone were assessed using the enzyme-linked immunosorbent assay. Results About 80% of the participants were males and 20% were females. Diagnosis according to the Diagnostic and statistical manual of mental disorders, 4th ed. (DSM-IV) showed that 29 (96.7%) of the patients were diagnosed with ADHD combined type by DSM-IV and only one patient (3.3%) had ADHD inattentive type. Forty percent of the patients were from low socioeconomic class, followed by 26.7% from moderate socioeconomic, and a very low socioeconomic class; however, 6.6% were from a high socioeconomic class. There was a statistically significant difference between cases and control groups in all components of Conners' Parent Rating Scale; all cases had higher means than the control group (P = 0.001). There was no significant difference between both the study group and their siblings in serum total T3, thyroid-stimulating hormone, T4 (P > 0.05). Fifty percent of the patients had no or only one comorbidity and 15 (50%) had two or more comorbidities. On comparing the two subgroups (group with no or one comorbidity and the other group with two or more comorbidities), we found that there were no statistically significant differences between the two groups in the IQ components test. There were only statistically significant differences between two subgroups in the social problem subscale of Conners' scale, which showed higher scores in the subgroup of patients with two or more comorbidities. Also, there were no statistically significant differences in the thyroid profile of the two subgroups and the thyroid functions were within normal. Conclusion Oppositional defiant disorder was the most common comorbidity. Social problems are common in children with ADHD with comorbidity. Children with ADHD have no thyroid dysfunction.

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Background

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.

Aim

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.

Methods

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.

Results

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.

Conclusion

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.

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Background It has been recently shown that electroencephalogram (EEG) paroxysmal abnormalities are frequently recorded in patients with autism despite the absence of seizures. Objective On the basis of the increasing evidence of EEG abnormalities in autism, the aim of this study was to detect the EEG abnormalities in relation to the degree of severity of autism. Patients and methods EEG was measured in 40 autistic children aged 2–12 years, in comparison with 40 typically developing matched children. The severity of autism was assessed using the Childhood Autism Rating Scale. Results We found that 50% of the autistic children had abnormal EEG findings. There was a statistically significant relation between the EEG abnormalities and the severity of autism. Moreover, there was a statistically significant relation between the site of the wave abnormalities and the severity of autism. Conclusion Our study suggests that the use of neurological investigative techniques such as EEG be considered routinely during the evaluation of autistic children.

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Introduction Patients with borderline personality disorder (BPD) are unique and diverse in their pathology, defense style, and clinical presentations. Many of these patients have other personality disorders as well. They tend to display a wide range of other psychiatric disorders, including dissociative phenomena and experiences. Patients and methods A total of 60 female patients were diagnosed with BPD using the Diagnostic and Statistical Manual of Mental Disorders, IV ed. Structured Clinical Interview for DSM-IV Axis II Personality Disorders. Severity of illness and emotional and behavioral aspects of patients were assessed using Borderline Evaluation of Severity over Time. Defense style of patients was assessed using the Defense Style Questionnaire. Dissociative phenomena were studied using the Dissociative Experience Scale (DES). Results The most commonly used defenses by the study patients were undoing, idealization, somatization, and splitting. Patients with absent criteria 4 (impulsivity) and 7 (feeling of emptiness) of BPD significantly displayed more mature defenses, whereas patients having criterion 9 (paranoid ideation and severe dissociation) of BPD significantly displayed neurotic type of defenses. Mature defenses were significantly negatively correlated with the absorption and depersonalization factors of DES. Neurotic defenses were significantly correlated with the total score of DES, absorption, and depersonalization factors. Immature defenses were significantly correlated only with the depersonalization factor of DES. Conclusion Patients with BPD have a specific pattern of defense style that might be linked to their specific illness criteria. Displaying certain phenomena of dissociation might be related to the particular pattern of the dominant defense mechanisms in these patients.

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Background The perimenopause marks a major life transition for women, an end to the childbearing years and cessation of menses. Women frequently face a number of major life stressors during the years leading up to menopause. Aim This study aimed to explore the biopsychosocial aspects of perimenopause, to study the distribution of menopausal symptoms in an urban versus a rural community, and to study the psychosocial profile of women with psychiatric disorders during the perimenopausal period and their impact on quality of life to evaluate their attitude toward menopause and its relation to the psychiatric disorders, and to focus on the possible relationship between estradiol level and psychiatric disorders in perimenopausal women. Patients and methods This study enrolled 50 perimenopausal women and 20 premenopausal women as a control group. Tools of the study We used the following tools: Structured Clinical Interview of DSM-IV, Stressful Life Events Scale, the Arabic version of Greene Climacteric Scale and Menopausal Symptom Checklist, the Quality of Life Scale for Menopausal Women, Attitude Towards Menopause, the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Sleep Questionnaire, and laboratory investigations including determination of follicle stimulating hormone serum level and serum estradiol level. Results In this study, the perimenopausal group had significantly (P < 0.001) greater stressful life events than premenopausal women (66% of perimenopausal women were at a definite risk for illness and 34% were at a moderate risk for illness). Perimenopausal women with psychiatric disorders had significantly greater stressful life events than those without psychiatric disorders. We also found that 36 (72%) perimenopausal women had significantly (P < 0.01) positive attitude compared with five (25%) premenopausal women. Perimenopausal women with psychiatric disorders had greater severity of menopausal symptoms (highly significant in hot flushes). Perimenopausal women with psychiatric disorders had poor quality of life and marked psychological limitations. In the present study, risk factors for patients with major depressive disorder were a family history of mood disorder, vasomotor symptoms, and stressful life events. Risk factors for generalized anxiety disorder were a family history of generalized anxiety disorder (GAD) and vasomotor symptoms. Conclusion It is important to assess the psychosocial profile, women's attitude toward menopause, menopausal symptoms, and screening for psychiatric disorders for better quality of life and better outcome.

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Aim

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.

Participants and methods

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.

Results

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.

Conclusion

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.

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