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   2012| January-April  | Volume 33 | Issue 1  
    Online since June 6, 2014

 
 
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EDITORIAL
New concept of depression and its management
Ahmed Okasha
January-April 2012, 33(1):1-8
DOI:10.7123/01.EJP.0000412301.27206.f1   
  4,979 237 -
ORIGINAL ARTICLES
Quality of life and burden of women with premenstrual dysphoric disorder
Nagda M. El-Masry, Nelly R. Abdelfatah
January-April 2012, 33(1):45-50
DOI:10.7123/01.EJP.0000411124.67583.a3   
Background

Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual physical and psychological discomfort. The disorder is common and has a negative impact on mental health and quality of life of women suffering from PMDD.

Aim

This study was carried out to evaluate the quality of life of women with PMDD.

Participants and methods

In a comparative case–control study, 34 patients with PMDD and 34 healthy controls (matched for age, educational level, and social class) were included. All were within the reproductive period.

Tools

Both groups were subjected to the following psychometric tools: a semistructured interview, a structured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders-fourth edition, the World Health Organization Quality Of Life instrument, the symptom checklist instrument, the psychological adjustment scale, and the Sheehan disability scale.

Results

Patients and control groups were matched for age (P=0.46), marital status (P=0.35), educational level (P=0.87), and socioeconomic status (P=0.84). The mean scores of psychological and social relationships domains on the World Health Organization Quality of Life (WHOQOL)-BREF were lower for patients compared with the healthy control participants. Differences were statistically significant for emotional, family, and social adjustment (P<0.001). There were statistically significant differences for somatization, obsessive-compulsive, depressive, and anxiety symptoms (P<0.001). The burden of PMDD was higher for the patient group compared with the healthy control participants (P<0.001). The family responsibilities domain was the most affected on the Sheehan disability scale.

Conclusion

Patients with PMDD have lower quality of life than healthy participants. They have maladjusted emotions, family relations, and social functioning. They experience higher somatization, obsessive-compulsive, depressive, and anxiety symptoms than normal participants. The burden of illness is high. Appropriate recognition of the disorder and its impact should lead to the treatment of women with PMDD. Effective treatments are available. They should reduce individual suffering and impact on families, society, and economy.

  2,795 228 2
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.

  2,552 258 3
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.

  2,408 161 3
Memory impairment in female schizophrenic patients and its relation with their female sex hormonal profile
Samia Abd EL-Rahman Ahmed, Ola Omar Shaheen, Amany Ahmed Abdou, Mohamed Nasr
January-April 2012, 33(1):29-34
DOI:10.7123/01.EJP.0000411114.33017.6a   
Hypothesis

Schizophrenic women show deficits in a variety of cognitive domains including executive function, attention, memory, and language. The female sex hormone estrogen acts as a neuroactive hormone that is assumed to have interesting effects on the central nervous system and on the cognitive functions in specific.

Aim of the work

To determine the memory impairment in a sample of schizophrenic female patients, as well as its relation to the level of their female sex hormone estradiol, to evaluate the usefulness of hormonal therapy as an adjunct therapy to antipsychotic drugs in female schizophrenic patients to improve their cognitive functions.

Participants and methods

This is a comparative study that included 30 schizophrenic female patients who were admitted for a long time as inpatients of Al Abasseia Psychiatric Hospital, and a control group that matched in age and education. They were subjected to a psychiatric interview, neurological examination, general examination, the scale for the assessment of positive symptoms, and scale for the assessment of negative symptoms, serum estradiol level during 3 consecutive weeks, and the Luria–Nebraska neuropsychological battery, which is a multidimensional battery designed to assess a broad range of neuropsychological functions. (We focused on the items that tested memory functions).

Results

There were statistically significant differences between both groups in the clinical scales C10 (memory) of the Luria–Nebraska neuropsychological battery, as well the factor scales concerned with memory ME1 (verbal memory) and ME2 (visual and complex memory). The mean estradiol level was inversely correlated with the mean of the memory scales; that is, an increased estradiol level was correlated with better performance of the patient group in memory scales.

Conclusion

Female schizophrenic patients performed significantly worse in the memory scale (C10), as well as the factor scales concerned with memory ME1 (verbal memory) and ME2 (visual and complex memory); the increased estradiol level was correlated with better performance of the patient group in memory scales, which may be of value in these patients when providing hormonal therapy as an adjunct therapy to antipsychotic drugs.

  2,262 90 -
Gender-related phenomenological and neuropsychological differences in elderly patients with depression
Fatma Moussa, Mohamed Nasreldi, Hani Hamed, Amany Ahmed Abdou
January-April 2012, 33(1):23-28
DOI:10.7123/01.EJP.0000411115.10146.c9   
Aim

The objectives of this work were to detect phenomenological sex-specific differences in elderly patients with depression for better understanding and to illustrate neuropsychological sex-specific differences in elderly patients with depression for better management.

Subjects

A comparative study with consecutive samples. Two groups were compared in the study comprising 40 elderly patients of both sexes with depression: 20 depressed men and 20 depressed women aged 60 years or above. They were recruited from the psychiatry outpatient clinic of Kasr Al Aini hospital with no obvious cognitive impairment or substance-related psychiatric disorders.

Methods

Diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, Symptom Checklist-90, mini-mental state examination (MMSE), Geriatric Depression Scale (GDS), Wechsler Adult Intelligence Scale, and State–Trait Anxiety Inventory were used.

Results

A comparison between the depressed male and female subgroups revealed that the characteristics of the patients were similar in both sexes except for some significant findings; for example, depression in elderly women is more associated with widowhood, more suffering from a sense of worthlessness, lack of attention, and more disturbance in reasoning and constructional abilities. However, elderly men reported more sexual dysfunction and a significant negative correlation between memory impairment (MMSE) and severity of depression (GDS).

Conclusion

There were no sex-specific differences in elderly depressed patients except that depression in elderly women was more associated with widowhood, a sense of worthlessness, lack of attention, and more disturbance in reasoning and constructional abilities, whereas elderly men reported more sexual dysfunction and a significant negative correlation between memory impairment (MMSE) and severity of depression (GDS).

  2,248 85 -
Depression and Alzheimer disease ( a risk factor or a prodrome)
Hoda Salama, Tarek Molokhia, Hazem Maarouf, Hesham Sheshtawy
January-April 2012, 33(1):19-22
DOI:10.7123/01.EJP.0000411507.77863.13   
Background

The number of elderly individuals in the population is steadily increasing. One of the well known problems in the elderly is cognitive impairment. Alzheimer disease is the most common cause of cognitive impairment. Another health problem in this age group that can present with cognitive impairment is depression. Several controversies exist regarding the relationship between depression and Alzheimer disease.

Aim

This work aims at studying whether depression can be a risk factor for future development of Alzheimer disease.

Patients and methods

Twenty patients with Alzheimer disease in the outpatient clinic were asked about their history of depression and the presence of depression at the onset of illness.

Results

One unmarried woman (5%) had a history of depression. Seven patients (35%) had depression at the onset of illness.

Conclusion

The current study supports the hypothesis that depressed mood is not a risk factor for future development of Alzheimer disease. Further studies are needed to assess the relationship between cognitive symptoms of depression and future development of Alzheimer disease.

  1,491 100 -
The role of the brain-derived neurotrophic factors in the progression of bipolar disorders
Heba Fathy, Shereen Mohamed Abd El-Mawella, Hoda Abdou, Amal Abdou
January-April 2012, 33(1):15-18
DOI:10.7123/01.EJP.0000411123.49083.e0   
Introduction

Bipolar disorder (BPD) is considered to be the most prevalent psychiatric conditions, and is also among the most severe and debilitating. It was suggested that the brain-derived neurotrophic factor (BDNF) plays an important role in the pathophysiology of mood disorders. BDNF appears to be an unspecific biomarker of neuropsychiatric disorders characterized by neurodegenerative changes.

Aim

The aim of the study was to investigate the association between BDNFs and progression of BPDs.

Participants and methods

After receiving approval from the ethical committee in kasr El Eini hospital, 80 participants were randomly selected in a comparative cross sectional study. The sample consisted of two groups: a group of patients with BPDs (n=40), including patients with manic, depressive, mixed episode, or in remission, and a control group (n=40). The patients were recruited from the psychiatric outpatient clinic. Patients were diagnosed by a lecturer of psychiatry according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria. Psychometric procedure: the Hamilton rating scale of depression and the Young Mania Rating Scale were used: laboratory: Radio-immune assay of BDNFs was carried out.

Results

Fifty-five percent of the patients in the bipolar group had three or more episodes. There was a statistically significant difference between the cases and the controls in the level of BDNF. There was a negative correlation between the BDNF and the number of episodes (P=0.000) and there was also a negative correlation between BDNF and disease duration (P=0.000). There were no correlations between BDNF and the diagnosis of BPD (P=0.3).

Conclusion

BDNF was lower than normal in bipolar patients and this was correlated with the number of episodes and duration of disease.

  1,485 79 -
Gender differences in personality characteristics and cognitive abilities in adolescents admitted in correctional institutes in Egypt
Amany Ahmed Abdou, Dalal Amer, Mohamed Nasreldin Sadek
January-April 2012, 33(1):9-14
DOI:10.7123/01.EJP.0000411074.34042.8e   
Objectives

To ascertain differences between male and female adolescents admitted to correctional institutes in Egypt with respect to their personality characteristics and cognitive abilities.

Methods

This cross-sectional study was carried out in two correctional institutes in Cairo. Fifty adolescents admitted after being convicted by court (25 male, 25 female) were randomly selected, assessed, and compared with an age-matched control group (N=25). Data on personal, sociodemographic, and criminal history were collected. They were subjected to the Wechsler Adult Intelligence Scale, the Wisconsin Card Sorting Test, the Eysenck Personality Questionnaire, The Hostility Questionnaire, and the Psychiatric Symptomatology Scale for adolescents.

Results

Of the students, 28% were male and 16% were female; 72% of male and 36% of female adolescents were working as unskilled manual workers. Male adolescents were more violent in their acts compared with female adolescents (48 vs. 8%); 12% of male adolescents were engaged in the use and sale of drugs compared with 8% of female adolescents; 44% of female adolescents were homeless compared with 4% of male adolescents; stress factors were mostly financial in male adolescents (88%), whereas in females sexual abuse was present in 24% in addition. Substance abuse was a dominant feature in both: 80% in male adolescents (nicotine smoking in 24% and polysubstance in 56%) and 64% in female adolescents (nicotine smoking in 44% and polysubstance in 20%). Adolescent girls had significantly higher scores in the adjustment disorder, identity disorder, and depression, bulimia, and sleep disorders on the symptomatology scale. They also had lower IQ in the total, verbal, performance, vocabulary, arithmetic, digit span, digit symbol, and block design scales of the Wechsler Adult Intelligence Scale. No significant difference was seen in the Eysenck Personality Questionnaire and in the Wisconsin Card Sorting Test.

  1,198 110 1