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   2015| May-August  | Volume 36 | Issue 2  
    Online since June 4, 2015

 
 
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ORIGINAL ARTICLES
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.
  7,506 610 7
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.
  4,776 438 4
A study of the personality traits and the level of anxiety in suicidal polydrug users
Magda T Fahmy, Wafaa L Haggag, Khaled A Mohamed, Amany A Baalash
May-August 2015, 36(2):106-111
DOI:10.4103/1110-1105.158119  
Background Suicidal behavior among substance abusers is common. Despite increasing knowledge about substance abuse and suicidal behavior, we lack sufficient knowledge about the characteristic features of suicidal substance abusers. Objective This study aimed to examine the associative characteristics of suicidal thoughts among polysubstance abusers. Materials and methods This was a case-control comparative study on 239 individuals between 18 and 45 years of age. We reviewed 122 individuals who fulfilled the DSM-IV-TR criteria of substance abuse for two or more substances, and their data were compared with that collected from 117 control persons. Detailed demographic, clinical, and laboratory data of the participants were collected. They were administered a semistructured psychiatric interview and examination, the Eysenck Personality Questionnaire (EPQ), and the Hamilton Anxiety Scale (Ham-A) on almost the 10th day after admission (after detoxification). Results Suicidal cases formed 64.75% of the polysubstance abusers in our study. The mean score of Ham-A was 13.71 ± 6.31 for suicidal polydrug abusers, which was significantly the highest among the groups; 24.1 and 6.3% of the suicidal cases experienced mild to moderate and moderate to severe anxiety, respectively, whereas the remaining experienced mild symptoms. Suicidal cases attained significantly higher scores on the psychoticism and lie scale of EPQ in this study. Conclusion A statistically significant relation was found between the suicidality in polysubstance abusers and a high level of anxiety as assessed by the Ham-A scale and personality traits related to psychoticism and the lie scale on EPQ.
  3,661 270 2
Prevalence and risk factors of metabolic syndrome among drug-naive psychotic patients
Nagy Fawzy, Amany El Shabrawy, Amira Youssef
May-August 2015, 36(2):101-105
DOI:10.4103/1110-1105.158118  
Objectives The aim of the study was to determine the prevalence and risk factors of metabolic syndrome among drug-naive psychotic patients. Patients and methods The sample consisted of two groups: group I had 65 drug-naive patients recruited from psychiatric outpatient clinics of Zagazig University Hospitals and group II had 65 participants selected randomly from among Zagazig University Hospital visitors. Patients were subjected to a semistructured psychiatric interview, using the DSM-IV criteria for diagnosis. Severity of symptoms was rated using the Positive and Negative Syndrome Scale. Detection of metabolic syndrome was based on the criteria of the International Diabetes Federation. Results The results of the study show that the prevalence of metabolic syndrome among drug-naive psychotic patients was 12% (eight patients). There was also significant correlation between sex and marital status and all metabolic syndrome criteria, between education and triglycerides level, and between age and waist circumference, blood pressure, triglycerides, and high-density lipoprotein levels. Conclusion The current study concluded that prevalence of metabolic syndrome is higher in drug-naive psychotic patients and psychosis is a risk factor for developing metabolic syndrome among drug-naive psychotic patients.
  2,742 242 2
Role of the serotonin transporter gene in susceptibility to mood disorders in children of depressed parents
Abdou E Eldod, Manal A Eid, Amr A Heba, Mohammad A Seleem, Noha F Fnoon
May-August 2015, 36(2):73-80
DOI:10.4103/1110-1105.158114  
Objective The aim of the study was to explore psychological and behavioral disturbances in a sample of Egyptian children with depressed parents and investigate the potential role of the short (s) alleles of the serotonin transporter-linked polymorphic region in developing depressive symptoms in both parents and their offspring. Subjects and methods The study included 20 families with depressed parents and their offspring (age 6-18 years), who were compared with 20 control families with healthy parents. The Child Behavior Check List was filled by parents for children to detect syndromal and subsyndromal symptoms of mood disorders and other psychiatric disorders in the offspring. Blood samples were drawn from all groups and PCR analysis was conducted to investigate the polymorphism of interest. Results The children of depressed parents scored higher than the children of control parents in almost all Child Behavior Check List internalizing and externalizing problem parameters. A significantly higher percentage of depressed parents (70%) were found to carry the risk allele (s) compared with control parents (35%) (P = 0.03). A similar, but nonsignificant, pattern of asymmetric allele distribution was also found among the offspring of the two groups (77.3 vs. 50%). Conclusion Parental depression must be recognized as a major risk factor of psychiatric morbidity in children. Greater emphasis should be placed on developing large-scale effective preventive interventions for families with parental depression.
  2,735 175 -
Tumor necrosis factor-a −308 G/A polymorphism in a sample of Egyptian patients with Alzheimer's disease
Afaf H Khalil, Adel G El Missiry, Nabil R Mohamed, Lamiaa G El Hamrawi, Afaf Z Rajab, Ahmed F AbdEl Aty
May-August 2015, 36(2):88-94
DOI:10.4103/1110-1105.158116  
Objective This study was designed to determine whether tumor necrosis factor-a ( TNF-a) −308 G/A polymorphism was a risk factor for late-onset Alzheimer's disease (LOAD) and/or was associated with a more severe form of LOAD in a sample of Egyptian patients. Background LOAD is a neurodegenerative disorder and the most common form of dementia affecting people over 65 years of age. Polymorphisms in the promoter region of the TNF-a gene have been reported to increase the transcription rate of the gene and thus might influence the risk for LOAD. Patients and methods This study enrolled 31 elderly patients diagnosed with probable Alzheimer's disease. The diagnosis was according to the DSM-IV-TR and the National Institute of Neurological and Communicative Disorders and Stroke and Alzheimer's Disease and Related Disorder Association (NINCDS-ADRDA). Thirty-one cognitively normal elderly controls were included and were subjected to the Clinical Dementia Rating Scale, the Activities of Daily Living scale, and the Instrumental Activities of Daily Living scale. Results The presence of the TNF-a −308 A allele was associated with an increased risk for LOAD, younger age of onset of LOAD by about 4 years, and statistically significantly more severe form of LOAD in Egyptian patients. Conclusion The TNF-a −308 A allele was a risk factor for the development of LOAD in Egyptian patients.
  2,602 142 -
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.
  2,431 210 4
Auditory mismatch negativity, P300, and disability among first-episode schizophrenia patients without auditory hallucinations
Nagy Fawzy, Osama Gado, Ahmed M Abdalla, Wailed M Ibrahim
May-August 2015, 36(2):112-117
DOI:10.4103/1110-1105.158120  
Objectives The aim of this study was to determine the functional deficits, including the inter-related domains of attention, memory, and information processing, among first-episode schizophrenia patients without auditory hallucinations. Such deficits could be evaluated objectively utilizing measurements of auditory-evoked potentials. Patients and methods The study sample consisted of two groups: group I included 58 first-episode schizophrenia patients without auditory hallucinations recruited from the psychiatric outpatient's clinics of Zagazig University Hospitals and group II included 53 participants selected randomly from Zagazig University Hospitals' visitors. Patients were subjected to a semistructured psychiatric interview using DSM-IV criteria for diagnosis, and auditory mismatch negativity (MMN) and P300 were assessed in schizophrenia patients before and after treatment. The degree of disability was assessed and its correlation with auditory processing function was determined. Results Our study showed no statistically significant difference as regards MMN measures with any observable effect of atypical antipsychotics; the P300 component showed delayed latency and smaller amplitude before treatment and markedly enhanced after treatment, and there was statistically significant correlation between the degree of disability and MMN, as well as P300 measures, before and after treatment. Conclusion The current study concluded that the attention-dependent processes reflected in P300 measures are already defective during the early stage of schizophrenia and could be improved with the use of an atypical antipsychotic medication.
  2,055 174 1