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ORIGINAL ARTICLES
Prevalence of substance abuse among adolescent school students in Zagazig
Mohamed G Negm, Amira A Fouad
September-December 2014, 35(3):161-166
DOI:10.4103/1110-1105.144344  
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.
  13 10,543 0
The impact of anxiety and depression during pregnancy on fetal growth and the birth outcome
Youmna Sabri, Hanan Nabel
May-August 2015, 36(2):95-100
DOI:10.4103/1110-1105.158117  
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.
  7 7,516 610
Public attitudes and knowledge toward epilepsy in ismailia governorate
Ahmed Osama, Mohammed Abd El Fatah El Smahy, Mona El sayed, Sabry Moawad
May-August 2016, 37(2):104-110
DOI:10.4103/1110-1105.193016  
Objective This study was conducted to find out knowledge and attitudes toward epilepsy among a sample of people living in Ismailia governorate in Egypt. Patients and methods A cross-sectional survey was conducted by using a face-to-face interview; 840 respondents were included, among whom 420 were from an urban area − Sheikh Zayed district − and 420 were from a rural area − Abu-Sultan village. The survey instrument was a 26-item questionnaire in Arabic form that was designed to evaluate knowledge and attitudes with respect to epilepsy. Results Of the 840 respondents, 91.2% had heard of or read about epilepsy, 24.8% knew someone with epilepsy, and 30.7% had witnessed a seizure. According to the respondents, the main cause of epilepsy was psychological disease (63.7%), followed by evil spirits (Jinn) (49.5%) and a form of insanity (47.4%). Approximately 70% of the respondents (70.7%) agreed that the intelligence of an epileptic patient is below average. About three-quarters of the respondents (74.6%) believed that epilepsy cannot be cured. More than 50% of the respondents believed that an epileptic patient could not get married (57.5%), nor have a child (58.7%). About 80% of the respondents refused to marry an epileptic patient (77.7%) or to marry their child to an epileptic patient (83.0%). Fifty-nine percent of the respondents would not offer a job to a person with epilepsy, and 41.1% refused working with an epileptic patients. The negative attitudes toward an epileptic person were more common among rural, female, less-educated, and elderly respondents. Conclusion Public perception of epilepsy is lacked and needs attention. The study revealed that practices and knowledge toward epilepsy were limited, especially with respect to epilepsy’s cause, manifestation, and management. Continuing effective educational interventions would be needed to improve the appropriate understanding of epilepsy, and to ameliorate the social discrimination and misconceptions against epilepsy.
  7 2,733 182
Physical and verbal aggression among adolescent school students in Sharkia, Egypt: prevalence and risk factors
Nagda M Elmasry, Amira A Fouad, Dalia M Khalil, Khalid S Sherra
September-December 2016, 37(3):166-173
DOI:10.4103/1110-1105.195547  
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.
  7 9,898 690
The role of culture and faith healers in the treatment of mood disorders in rural versus urban areas in United Arab Emirates
Khalid S Sherra, Mohamed Shahda, Dalia M Khalil
May-August 2017, 38(2):79-89
DOI:10.4103/1110-1105.209678  
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.
  7 5,743 382
Sexual risk among substance users and its relation to personality profile
Momtaz Abd-Elwahab, Mohamed Ezzat Amin
September-December 2012, 33(3):135-141
DOI:10.7123/01.EJP.0000415088.97056.8a   
Objectives

To study sexual behavior among substance users, to find an association between substance use and risky sexual behaviors, and to determine whether there is an association between personality traits and risky sexual behaviors among substance users.

Participants and methods

Our participants (100) were divided into two groups: group 1 (cases) included 50 individuals (diagnosed with substance abuse according to the DSM-VI criteria) recruited from the Kasr El Aini psychiatric inpatient ward and group 2 (controls) included 50 normal control individuals, matched for age, sex, and socioeconomic status. All patients were men, ranging age from 18 to 40 years, were taking substances for at least 6 months, and all of them could read and write. Those with a comorbid axis I diagnosis were excluded from the study. Both groups were subjected to a full psychiatric sheet, risk assessment battery (RAB), and the Eysenck personality questionnaire. The Addiction Severity Index was determined for cases, urine sampling was carried out using drug screening strips, and a laboratory test was performed for HIV and hepatitis C virus detection.

Results

Both groups showed nonsignificant differences in terms of age, education, employment, education, and social status. The most prevalent substance used was tramadol (96%), followed by cannabis (72%) and heroin (58%). Hepatitis C virus infection was detected in (16%); none of the patients had HIV (AIDS). There were statistically significant differences in extroversion and neuroticism between the cases and the controls. There was a statistically significant difference between the cases and the controls in terms of the sexual subscale of RAB. There was a significant correlation between psychoticism and criminality subscales in Eysenck Personality Questionnaire and the RAB in the case group.

Conclusion

Patients with substance abuse have more sexual risk than normal controls. Sexual risk is not related to the severity of addiction, but to psychoticism and criminal behavior of personality.

  5 2,508 206
Anxiety, depression, and strain among caregivers of terminally ill patients
Fadia Zyada, Mohamed sheta, Hanaa El Degwi, Rasha Saad
May-August 2013, 34(2):77-84
DOI:10.7123/01.EJP.0000419667.93575.14   
Aim

To describe the characteristics of informal caregivers of terminally ill (hepatic, cardiac, and renal failure) patients and their care recipients and to examine the relationship between depression, anxiety, and burden among informal caregivers.

Participants and methods

This was a cross-sectional study, in which 51 caregivers of terminally ill (hepatic, cardiac, and renal failure) patients were recruited from among inpatients of Internal Medicine Department, Kasr Al Aini, Faculty of Medicine, from September 2011 to April 2012. The patients were subjected to a Caregiver Questionnaire, Hamilton Anxiety Rating Scales, and Hamilton Depression Rating Scales, and the Modified Caregiver Strain Index was determined.

Results

Most of the caregivers experienced high levels of burden, severe anxiety, and mild depression. Several factors showed a statistically significant correlation with caregiver burden, anxiety, and depression including the care recipient’s functional status, personality changes, mental functioning, the presence of comorbidity, the Palliative Prognostic Score, being the main caregiver, duration of caregiving, the caregiver’s employment status, perceived health, and impact on social activities. Caregiver burden, anxiety, and depression were significantly correlated.

Conclusion

Caregivers of terminal organ failure (hepatic, cardiac, and renal) patients experience high levels of burden, severe anxiety, and mild depression. Predictors of anxiety, depression, and burden include being the main caregiver, duration of caregiving, the caregiver’s employment status, perceived health, and impact on social activities.

  5 3,110 363
The prevalence of obesity in a sample of Egyptian psychiatric patients
Ahmed Kamel, Hesham Abuhegazy, Ali Ismaila, Khalid Sherra, Mohammed Ramadan, Abdullah Mekky, Ali Al Nabawy
September-December 2016, 37(3):157-165
DOI:10.4103/1110-1105.195546  
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.
  5 5,526 381
Cognitive impairment and pregabalin dependence
Abouzed Mohamed, Emam M
January-April 2020, 41(1):14-18
DOI:10.4103/ejpsy.ejpsy_34_19  
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.
  5 5,715 250
Dehydroepiandrosterone sulfate and testosterone levels correlate with negative symptoms in male patients with schizophrenia
Haitham M. Hashim, Mohmed G. Negm
September-December 2012, 33(3):181-185
DOI:10.7123/01.EJP.0000416070.97156.25   
Background

Clinical studies have shown greater sex differences in symptoms of schizophrenia, with men having more negative symptoms than women, which may be related to the action of the reproductive hormones.

Objective

The aim of this study was to determine the relationship between negative symptoms and the plasma levels of testosterone and dehydroepiandrosterone sulfate (DHEAS) in male patients with schizophrenia.

Participants and methods

The participants were 50 male patients with chronic schizophrenia. The psychopathology of the patients was assessed using the Positive and Negative Syndrome Scale (PANSS). The Calgary Depression Scale for Schizophrenia (CDSS) and the Drug-induced Extrapyramidal Symptoms Scale (DIEPSS) were also used to exclude the effects of depression or drug-induced extrapyramidal symptoms.

Results

The PANSS negative scores showed a significant inverse correlation with the serum testosterone levels without a correlation with serum DHEAS.

Conclusion

This study indicates that testosterone but not DHEAS may play an important role in the severity of negative symptoms in male patients with schizophrenia.

  4 1,558 188
Gender differences in executive functions and reading abilities in children with attention deficit hyperactivity disorder
Rim Roufael, Azza El-Bakry, Dalal Amer, Osama Refaat, Maha Emad-Eldin
May-August 2012, 33(2):63-73
DOI:10.7123/01.EJP.0000413587.34899.c5   
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.

  4 5,456 325
A survey on the significance of psychological and psychiatric assessment among qualified African football referees
Shewikar T El Bakry
May-August 2013, 34(2):85-92
DOI:10.7123/01.EJP.0000418693.73007.54   
Purpose

The present study was carried out to investigate why psychiatric and psychological examinations are neglected during periodical medical examinations for football referees.

Patients and methods

A total of 42 certified male referees were randomly selected from the Sports Medicine Specialized Center situated at Nasr City, Cairo Governorate, Egypt. All participants were registered at the African Confederation of Football. Male adult referees with ages ranging from 29 to 43 years were included in the study. Questionnaires related to the demographic personal characteristics, anxiety, physical health, stress, burnout, and depression were filled out by the participants.

Results

The mean age of the participants was 40±3.35 years. Of the participants, 34 were unmarried and eight were married; 32 participants did not have children and 10 did. A total of 36 participants had recieved higher education and six recieved only high school education. Participants were under moderate training schedules of 5 sessions/week of 1½–2 h each and had moderate years of experience (30–50 matches/year). With regard to the Burnout Anxiety Inventory, 63.3% of the participating referees showed no signs of anxiety, 18.4% were at borderline, 15.9% showed mild signs, and 1% presented with moderate records. With regard to the mind over mood depression scores, 35 participants showed no signs, whereas only two showed low signs. The Beck Depression Inventory scores of all participants was in the range of 0–7, that is, they had normal levels of depression. The physical wellness scores of 31 participants were recorded as excellent, whereas five recorded only average scores. With respect to the life stress scores, 67% of participants had normal life stress scores compared with 33% who were more prone to suffer or experience illnesses or accidents from life stress incidents. The Burnout Inventory scale revealed that 47.05% of participants had little signs and 52.95% showed low signs of burnout, with none being at risk. The Maslach results were also in concordance, according to which only one referee suffered from a burnout.

Conclusion

Thus, it may be deduced that, although the present levels of burnout may not be high, there is always potential for it to increase. Thus, programs on burnout are suggested to be included in training courses for referees to prevent the start of symptoms. It is therefore recommended that physical checkup be supplemented with psychiatric and psychological examinations in the periodical assessments of physical health for football referees.

  4 1,773 201
Caudate nucleus volume in schizophrenia, bipolar, and depressive psychosis
Maha ELTayebani, Mamdoh ElGamal, Osama Gado, Mohamed Samer Abdelaal
January-April 2014, 35(1):1-13
DOI:10.4103/1110-1105.127264  
Introduction The caudate nucleus (CN) is a crucial component of the ventral striatum and part of the striatal-thalamic circuits that is modulated by limbic structure to subserve emotional processing. MRI studies examining the CN have yielded equivocal, mixed results. We aimed to examine the CN size and its clinical, cognitive correlates in drug-naive patients with first-episode psychosis. Materials and methods (i) The CN was manually traced on MRI scans from 49 schizophrenic patients, 21 bipolar patients, and 20 patients with depressive psychosis as well as 23 healthy control individuals both at baseline and after 2 years. (ii) Structured SCID interviews of DSM-IV, HDRS, YMRS as well as PANSS were conducted. (iii) WMS-III and WAIS were used to test cognitive function and finally, the Simpson-Angus Scale for extrapyramidal Parkinson features. Results (i) CN size was significantly more reduced in bipolar patients than in healthy controls with a magnitude of around 18.5%. (ii) Schizophrenic and depressive patients showed a modest volume reduction in CN (8.5 and 12.5%, respectively). (iii) Only bipolar patients showed cognitive dysfunction associated with a 1% progressive reduction in CN size after 2 years of follow-up. Clinical importance was unclear for depressive and schizophrenia patients. Conclusion and recommendation CN volume reduction in bipolar psychotic patients may reflect part of the pathophysiology of the illness, but it is unclear whether it is primary or secondary to other structural changes. Study of the shape, functional changes in CN as well as areas connected to it may uncover the primary mechanisms of bipolar psychosis.
  4 4,678 235
The impact of attention-deficit hyperactivity disorder across the lifespan on substance use disorders
Hoda Salama, Soha Ibrahim, Osama Abou El Magd, Ahmed Abdel Kerim
May-August 2015, 36(2):66-72
DOI:10.4103/1110-1105.158113  
Introduction Attention-deficit hyperactivity disorder (ADHD) affects not only children, but persists into adulthood with a prevalence rate up to 4.4% in the general population. The association between ADHD and substance use disorders (SUDs) is getting more into the scientific focus. However, the impact of ADHD on SUD regarding the economic system and healthcare is still underestimated. Aim of the work The aim of this study was to analyze the impact of childhood and adult ADHD on SUD by comparing the SUD clinical outcome between a group of SUD inpatients having a history of childhood ADHD and another group of SUD inpatients having concurrent adult ADHD. Participants and methods A cross-sectional comparative study was conducted at the Addiction Treatment Center at El Maamoura Mental Hospital. In all, 102 adult male patients were assessed using a clinical psychiatric interview and psychometric assessment using the Arabic version of Wender Utah Rating Scale for retrospective assessment of symptoms of childhood ADHD. Also, the Arabic version of the Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist was used to screen for adult ADHD. Results Sixty-four patients out of the total studied sample had a history of childhood ADHD. Of them, only 36 patients fulfilled the DSM-IV-TR criteria for adult ADHD. The presence of adult ADHD was associated with an earlier mean age of onset of SUD (13.22 vs. 14.86 years), a larger number of hospital admissions (4.21 vs. 6.83 times), and a shorter mean period of abstinence (124.53 vs. 271.50 days) than patients with a history of childhood ADHD. Conclusion In comparison with childhood ADHD, the presence of adult ADHD among patients with SUD was associated with a more complicated course of SUDs and a poorer clinical outcome.
  4 4,796 441
A study of serum interleukin-12 in a sample of autistic children in Egypt
Soha Ibrahim, Tarek El-Waleely, Nermine Zakaria, Rania Ismail
May-August 2015, 36(2):81-87
DOI:10.4103/1110-1105.158115  
Introduction Autistic spectrum disorders (ASDs) prevalence varies widely by sex and the racial/ethnic group. The male-to-female ratio ranged from 3 to 4 : 1. Some consider ASD to be an autoimmune disorder, in which the autoimmune response to the developing brain myelin may impair anatomical development of neural pathways in autistic children; this affects the speed of impulse transmission. Interleukin-12 (IL-12) is an interleukin that is naturally produced by dendritic cells and macrophages in response to antigenic stimulation; it plays an important role in the activities of natural killer cells and T lymphocytes involved in the immune system. Aim of the work The present study was conducted to compare the level of serum IL-12 between children with autistic disorder (AD) and healthy control children, and also to study the relation of serum IL-12 with the severity of autistic symptoms. Participants and methods A cross-sectional study was conducted on two groups; group I included 20 patients with AD and group II included 20 normal children matched for age and sex, recruited from the Child and Adolescent Outpatients Clinic at Al Hadra University Hospital. All children were subjected to a complete psychiatric history, physical and neurological examination, psychometric assessment by Childhood Autistic Rating Scale, and estimation of serum IL-12 using the enzyme-linked immunosorbent assay method. Results The mean serum level of IL-12 was significantly higher in AD children than in controls and was related to a younger age, male sex, a positive family history and ante/natal/postnatal history, nondevelopment of spoken language, the presence of comorbidities, and higher Childhood Autistic Rating Scale mean scores. Conclusion The study pointed out an immunological impairment in the form of an elevated serum level of IL-12 in autistic children and its positive relation to autistic symptom severity. This supports the immunological etiology of ASD.
  4 2,435 210
A study of opioid dependence among Mansoura University students
Rehab M Mahgoub, Mohamed A El-Hadidy, Mohamed F Abo El Hoda, Mohamed H Atrouny
September-December 2016, 37(3):174-179
DOI:10.4103/1110-1105.195548  
Background The prevalence of opioid dependence is increasing in the world and in Egypt among university students, which because of many false concepts being adopted. Objectives This study was conducted to detect the prevalence and the effects of opioid dependence among a sample of Mansoura University students. Participants and methods The study was carried out on 700 male students, aged 18–25 years. All students were assessed using semistructured interview and urine drug screening. Students were divided into three groups: the first group comprised 300 students who were not drug users, the second group comprised 300 polysubstance users, and the third group comprised 100 solitary opioid users. The first and third groups were subjected to psychometric assessment using Mini Neuropsychiatric Interview for substance dependence, Arabic version. Psychometric assessment was performed with the following tools: Wisconsin Card Sorting Test, Hamilton rating scale for depression, and PANSS positive and negative symptom scale; laboratory investigations included liver function tests and kidney function test. Results We found that out of 100 students who were opioid users, 88 students used tramadol and 12 used heroin. Liver and renal functions were nearly normal in cases, with a high statistically significant difference between cases and controls regarding serum glutamic oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT), and creatinine. Higher scores for Hamilton scale for depression and trail A and B mean values were found in cases compared with controls. Conclusion The prevalence of tramadol dependence among Mansoura University students is higher than heroin dependence. In addition, opioid dependence has a negative biological and psychiatric sequelae, which is contrast to the false concepts of opioid dependence.
  4 3,282 275
A study of child physical abuse
Hiame F Elsaied, Abdallha A Alsehly
May-August 2017, 38(2):120-126
DOI:10.4103/1110-1105.209674  
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.
  4 8,315 506
EEG abnormalities and severity of symptoms in non-epileptic autistic children
Amira M Yousef, Usama M Youssef, Amany El-Shabrawy, Nelly R.A. Abdel Fattah, Haytham Khedr, Haytham Khedr
May-August 2017, 38(2):59-64
DOI:10.4103/1110-1105.209676  
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.
  4 4,664 312
Metabolic syndrome in psychiatric patients (comparative study)
Fatma A Mousa, Hani H Dessoki, Sarah M El Kateb, Ahmed A Ezzat, Mohamed R Soltan
September-December 2017, 38(3):179-191
DOI:10.4103/ejpsy.ejpsy_24_17  
Background It is generally estimated that metabolic syndrome (MetS) is especially common in patients with severe mental illness, with a high prevalence ranging from 30 to 60% for schizophrenic and bipolar disorders, which predispose them to further medical complications up to premature death. Objective The aim of this study was to compare the prevalence of MetS in patients with major depressive disorder (MDD), schizophrenic patients, and healthy general individuals, and to assess the relation between cortisol levels and presence of MetS. Patients and methods The study included 120 participants (40 patients with drug-naive MDD, 40 patients with drug-naive schizophrenia, and 40 healthy individuals who served as the control group). Full history was taken. Blood pressure and waist circumference (WC) were measured and BMI was calculated. Laboratory investigations were carried out, including fasting blood glucose (FBG), serum triglycerides, serum high-density lipoprotein, and a morning level of serum cortisol. Results The study revealed a similar prevalence of MetS in the MDD and the schizophrenic group (27.5%) compared with a prevalence of 22.5% in the control group. The WC and the BMI were significantly higher in the MetS patients of the MDD and the schizophrenic group compared with those of the control group. FBG was significantly higher among MetS patients in the MDD group as compared with those in the schizophrenic and the control group. Cortisol level was significantly higher in MetS patients in the MDD and the schizophrenic group as compared with those in the control group. Conclusion The prevalence of MetS is higher in MDD and schizophrenic patients than in the general population, and is related to high WC, BMI, FBG, and serum cortisol. Hence, screening of such patients for metabolic disturbances is recommended.
  4 3,471 234
Prevalence and symptoms of premenstrual dysphoric disorder in a sample of psychiatric patients at Zagazig University Hospitals
Mohammed G Sehlo, Usama M Youssef, Rehab S Mahdy, Hayam El-Gohari
May-August 2018, 39(2):83-88
DOI:10.4103/ejpsy.ejpsy_36_17  
Introduction Premenstrual dysphoric disorder (PMDD) is a severe and disabling form of premenstrual syndrome affecting 3–8% of menstruating women. The relationship between PMDD and psychiatric disorders is still unclear. Aim The aim of this study was to assess the prevalence and symptoms of PMDD in a sample of psychiatric patients. Patients and methods A sample of psychiatric outpatients and inpatients who attended for treatment was clinically diagnosed according to Diagnostic and Statistical Manual of Mental Disorders-5 by clinical interview and by applying the premenstrual symptoms screening tool for diagnosis of PMDD. Results The prevalence of PMDD among cases and controls was 40.5 and 7.6%, respectively. PMDD was most prevalent among depressed patients (96.4%) followed by those with bipolar diseases (38.5%) and was less frequent among anxiety and psychotic patients (4.5 and 1.8%, respectively). Conclusion PMDD is highly related to psychiatric disorders especially depression and bipolar disorder.
  4 3,008 251
Folate, vitamin B12, and negative symptoms in schizophrenia
Shereen M Abd El Mawella, Hoda A Hussein, Talal Ahmed
May-August 2018, 39(2):89-94
DOI:10.4103/ejpsy.ejpsy_39_17  
Introduction Negative symptomatology has been demonstrated to be the most relevant predictor of increased future socio-occupational dysfunction and poorer quality of life. Negative symptoms and functional outcomes have consistently been linked, with several studies reporting worse functional outcomes in individuals with more prominent negative symptoms. Folate deficiency has been identified as a risk factor for schizophrenia and its negative symptoms. Aim The aim of this study was to assess the serum levels of folate and vitamin B12 in a sample of schizophrenic patients and their relation to negative symptoms in these patients. Patients and methods It is a cross-sectional study aiming to assess the serum level of folate and vitamin B12 in schizophrenic patients. All patients were recruited from the Kuwait Center for Mental Health after taking approval from the scientific and ethics committee of the hospital. The study was conducted in the period from January 2016 to April 2016; the total number of patients was 41 after applying the inclusion and exclusion criteria. We applied the Positive and Negative Syndrome Scale and the Scale for the Assessment of Negative Symptoms; serum levels of vitamin B12 and folate were measured by radioimmunoassay technique. Results About 41.5% of the patients have low folate level and about 39% of the patients have low B12 level. There are significant positive correlations between severity of negative symptoms and duration of illness and number of hospital admissions. Also there are significant positive correlations between serum levels of vitamin B12 and folate. There are significant negative correlations between serum levels of vitamin B12. All negative symptoms were assessed by the Scale for the Assessment of Negative Symptoms (affective flattening, alogia, attention, aviolation, and anhedonia). We cannot find a significant correlation between serum levels of folic acid and negative symptoms. Conclusion Folate and vitamin B12 deficiency may be a risk factor for schizophrenia and negative symptoms; so we suggest to evaluate the serum vitamin B12 and folate levels for schizophrenic patients followed by dietary supplementation for patients with low vitamin B12 or folate.
  4 4,776 332
A study of psychiatric comorbidities in irritable bowel syndrome
Victor S Michael, Mohamed M El Hamady, Shewikar T El-Bakry, Mona M.S Awd
September-December 2018, 39(3):140-149
DOI:10.4103/ejpsy.ejpsy_9_18  
Background Irretable bowel syndrome (IBS) is a functional syndrome characterized by chronic abdominal pain accompanied by altered bowel habits. Stress often worsens the symptoms of patients with IBS. Psychiatric disorders and IBS appear to have bidirectional comorbidities. Objectives The aim of this study was to assess the psychiatric comorbidities in patients with IBS. Patients and methods The study included a total number of 150 patients complaining of IBS symptoms with at least one episode of abdominal pain or flatulence per week in association with a change in bowel habit. All patients in the study were subjected to a detailed history taking and complete general and local abdominal examination. Moreover, International Classification of Diseases-10th revision internal medicine criteria for diagnosis, International Classification of Diseases-10th revision symptom checklist for mental disorders, and social readjustment rating scale were estimated. Results Patients of all age groups visit the clinics when they complain from IBS, mostly those of ages ranging from 31 to 40 years, who represented 38% of the studied group. Females complained more than males (66 and 34%). The most frequent psychiatric comorbidity with IBS was the neurotic and behavioral syndromes (53.3%) followed by psychotic and affective syndromes (32%), then the organic mental and psychoactive substance use syndrome (8%), and lastly, the personality disorders (4%). There was a significant association between IBS type and depression, generalized anxiety disorder (GAD), panic disorder, obsessive compulsive disorder (OCD), and somatization. Moreover, there was a significant correlation between IBS type and bipolar disorder, depression, GAD, panic disorder, OCD, somatization, and nonorganic sleep disorder. Conclusion Most patients with IBS have associated psychiatric or somatic comorbidities or overlapping other functional gastrointenstinal disorder (FGIDs). Patients with IBS have significantly higher levels of psychiatric comorbidities than healthy ones and are more susceptible to stress-related disorders.
  4 3,513 273
Comparison of family burden, quality of life, and disability in obsessive compulsive disorder and schizophrenia in Zagazig University Hospitals
Mohamed G Negm, Rehab S Mahdy, Abd Alshafi M Khashaba, Rafik R Abd El-Latif
January-April 2014, 35(1):39-44
DOI:10.4103/1110-1105.127276  
Background Obsessive compulsive disorder (OCD) is a chronic psychiatric disorder and it is one of the 10 most disabling medical conditions worldwide. Patients with severe OCD may have comparable level of global functioning, family burden, quality of life (QoL), and disability as patients with schizophrenia. Patients and methods We selected 100 patients (50 with OCD, 50 with schizophrenia) from Zagazig University Hospitals, psychiatric outpatients' clinics. Some of these patients were admitted and became inpatients whereas the rest continued to attend follow-up as outpatients to assess family burden, QoL, and disability. Results Deleterious effects of illness on families, patients' QoL, and functioning occur not only in schizophrenic but also in OCD patients. Symptom severity and noncompliance on maintenance treatment are associated with greater disability and poor QoL. Conclusion Management should be planned with these considerations to enhance functioning and QoL and thus decrease disabilities.
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Cognitive functions in euthymic adolescents with juvenile bipolar disorder
Lamis El Ray, Aref Khoweiled, Hoda Abdou, Shreen Abd El-Mawella, Mai Abdel Samie
January-April 2012, 33(1):40-44
DOI:10.7123/01.EJP.0000411121.54126.e5   
Introduction

Bipolar disorder in adolescents is often referred to as juvenile bipolar disorder. A peak in the prevalence of bipolar disorder has been documented between the ages of 15 and 19 years. Wide-ranging neuropsychological deficits have been found in many studies of juvenile bipolar disorder. Persistent neuropsychological deficits present in the euthymic state suggest that such deficits could be vulnerability trait markers of the illness.

Aim

To identify and assess cognitive functioning in euthymic adolescents diagnosed with bipolar disorder.

Participants and methods

A case–control cross sectional study, in which 30 euthymic bipolar adolescents were recruited from the psychiatric adolescent clinic of Kasr al Ainy and compared with 30 healthy controls.

Psychometric procedure

The Hamilton Rating Scale of Depression, the Young Mania Rating Scale, the letter cancellation test, the digit span and digit symbol/coding tests, the Bender gestalt test and the Wisconsin card sorting test were used.

Results

Cases had significantly higher mean scores than controls in the letter cancellation test and its omission errors as well as in the perseverative errors of the Wisconsin card sorting test, and lower mean scores in the digit span, digit symbol coding and the Bender gestalt tests. There was a significant positive correlation between the number of omission errors on the letter cancellation test and both of the number of manic episodes and the age of onset of the illness.

Conclusion

There are neuropsychological deficits in the areas of sustained attention, set shifting, processing speed and visual and auditory short-term memory in euthymic bipolar adolescent patients, type I. There is a significant correlation between the number of manic episodes as well as age of illness onset and sustained attention.

  3 2,548 178
Impact of the first national campaign against the stigma of mental illness
Nahed Khairy, Emad Hamdi, Albert Sidrak, Noha Sabry, Mohamed Nasreldin, Aref Khoweiled, Nasser Loza
January-April 2012, 33(1):35-39
DOI:10.7123/01.EJP.0000411119.59113.6e   
Background

Egypt experienced its first nationally televised antistigma campaign in 2007. This independent study aims at a scientific evaluation of the potential benefits of this campaign.

Methods

Two educational clips lasting 1 or 2 min each were aired daily on prime time television between 1 and 31 October 2007. Five messages were relayed as the clip rolled on. A specially designed questionnaire covering six areas was used; these included demographics, identifying those who have seen the clips, memory and opinion about each message, stigma-related attitudes, and behavior toward the mentally ill persons. Twenty mental health workers with experience in field work ranging in training from 1 to 13 years received two training sessions. The questionnaire was piloted on 82 participants and subsequently modified. A total of 3000 participants who consented to being interviewed were selected to participate. The data of 2274 participants from the Greater Cairo region are reported in this study (75.8%).

Results

The study sample is more representative of the younger, as only 21% of the sample were above 46 years, educated, as only 18% were illiterate, married, as 55% of the sample were married, and employed sections of the population. A total of 55% reported that daily life stressors were the cause of mental illness. Only 17% of the study sample actually acknowledged seeing the antistigma adverts (campaign exposed, CE) and 83% were campaign unexposed. There were no statistically significant demographic differences between both groups. Among those who saw the campaign adverts, a significant proportion reported a number of positive effects on attitude and behavior. However, when CE and campaign unexposed participants were compared, no statistically significant differences emerged. A total of 50% of the participants remembered that mental illness is curable. The question that psychiatric patients are dangerous to self or others showed a statistically significant difference between participants who were CE and those who were not exposed.

Conclusion

The public were willing to express their opinions as they showed significant cooperativeness and validity of their answers, especially those exposed to the campaign. The television is the medium of choice that the public prefer is the evidence stated in the paper. The antistigma media campaign leads to changes in the attitude of participants who are exposed to mental illness. Positive messages influenced attitude change more.

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* Source: CrossRef