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  Citation statistics : Table of Contents
   2016| September-December  | Volume 37 | Issue 3  
    Online since December 13, 2016

 
 
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ORIGINAL ARTICLES
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.
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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.
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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.
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Functional outcome in childhood-onset schizophrenia in Nigeria: a 3-year longitudinal study
Musa U Umar, Shehu Sale
September-December 2016, 37(3):118-124
DOI:10.4103/1110-1105.195549  
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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Neurological soft signs and insight in obsessive–compulsive disorder
Nagda M Elmasry, Amira M Youssef, Amany E Mohamed, Waleed R Ashour
September-December 2016, 37(3):125-131
DOI:10.4103/1110-1105.195543  
Background Obsessive–compulsive disorder (OCD) is an anxiety disorder characterized by the presence of obsessions and compulsions that interfere with the patient’s life. It has been shown that patients with OCD have increased rates of neurological soft signs (NSS) when compared with healthy controls. NSS are minor abnormalities like poor motor coordination, sensory and perceptual difficulties, and difficulties in sequencing of complex motor tasks. It has been suggested that OCD patients with poor insight are at the most severe end of this spectrum. Aim of the work The aim of this study was to determine the frequency pattern of symptoms (obsessions and compulsions) in OCD patients, to examine NSS in patients compared with healthy individuals, and find any correlation between NSS scores and the severity of OCDs [total Yale Brown Obsessive Compulsive Scale (YBOCS) score] and the degree of insight. Participants and methods The study included two groups: 30 OCD patients and 30 healthy individuals as controls. Both groups were subjected to psychiatric and neurological examination using the Cambridge Neurological Inventory (Part 2), the YBOCS checklist to detect types of obsessions and compulsions, and the Overvalued Ideas Scale to assess the degree of insight in OCD patients. Results The most common types of obsessions and compulsions among the patients were religious (70%), contamination (77%), and cleaning compulsions (77%). OCD patients recorded significantly higher total scores of NSS and domain scores (motor coordination, sensory integration, and primitive reflexes) compared with the control group (P<0.05). A positive correlation was found between NSS scores and total YBOCS scores and Overvalued Ideas Scale scores. Conclusion We conclude that OCD patients have higher scores for NSS compared with controls, particularly for motor coordination signs. NSS positively correlated with the severity of disease. There was a positive correlation between NSS scores and OVIS scores, which measures the degree of insight.
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Emotional empathy and cognitive styles in psychodynamic group therapy: UAE experience
Hala Fakhry, Sherif M Gohar, Mohamed A Khalil, Maged A Gomaa, Monem Reham Abdel, Afra Salem
September-December 2016, 37(3):132-147
DOI:10.4103/1110-1105.195544  
Background Practice of group therapy has been unexpectedly accepted against the presumption that patients could reject the idea of self-disclosure in the presence of strangers. Objectives The present study was designed to study group psychotherapy experience in the United Arab Emirates (UAE). The group cohesion process along the time of therapy was studied. A trial was also carried out to explore the impact of attending such groups on aspects of thinking described as cognitive styles as fears of failure and anger expression, as well as cognitive orientation of emotions and empathy. Patients and methods In the present case–control study, 80 patients (40 males and 40 females) between 19 and 45 years of age with different DSM-IV psychiatric diagnoses were recruited and subdivided into four groups. Each group included 20 patients − 20 males and 20 females allocated to attend group therapy [male group (MGp) and female group (FGp)], whereas the other 20 males and 20 females were allocated into comparative groups not attending group therapy [male comparative (MCm) and female comparative (FCm)]. All groups were further compared with frequency-matched healthy volunteers who served as control groups consisting of 20 males in the MCl group and 20 females in the FCl group. Sharing groups were subjected to clinical psychiatric examination and baseline psychometric assessment using Fear Of Failure (FOF1), Trait Meta Mood Scale (TMMS1), Arabic Anger Scale (AAS1), and Emotional Empathy Scale (EES1). Each patient in the male group (MGp) and the female group (FGp) attended at least 40 sessions in closed groups for 1 year. Group cohesion was assessed monthly using The Group Cohesiveness Scale (GCS) (1–12) for both groups. Psychometric re-evaluation at the end of 1 year was performed for all groups using the same tests − FOF2, TMMS2, AAS2, and EES2. All available scores were subjected to statistical analysis. Results Baseline readings showed statistically significant higher scores of FOF1 and AAS1 in patients compared with controls (P<0.00001) and lower scores of TMMS1 and EES1 (P=0.0020 for the three male groups and P<0.00001 for the three female groups). However, differences between groups of patients [(MGp vs. MCm) and (FGp vs. FCm)] were nonsignificant for FOF1 (P=1 and 0.28809), AAS1 (P=1 and 0.5186), TMMS1 (P=0.6326 and 0.6773), and EES1 (P=0.7491 and 1). In general, females showed more regular attendance during group sessions compared with males, but the difference was nonsignificant statistically. Patients’ assessment of group cohesion generally increased along the 12 months as denoted by GCS scores. Patients attending group therapy demonstrated variable levels of improvements compared with other groups of patients not attending group therapy and compared with controls. FOF2 demonstrated definite improvement in the MGp compared with the MCm group (P=0.0283) and in the FGp compared with the FCm group (P=0.0480); however, improvement was beyond normality compared with control groups (P<0.00001). EES2 demonstrated definite improvement in the MGp compared with the MCm group (P=0.01813) and in the FGp compared with the FCm group (P=0.038434), and improvement reached normality compared with control groups (P is nonsignificant). All TMMS2 scores of patient groups increased on treatment regardless of attending group therapy or not. Improvement in males reached normal levels compared with controls (P=0.1220 for the three male groups), but not in female patients (P=0.0021 for FGp vs. FCl). However, FGp patients showed more improvement than the FCm group (P=0.0044). AAS2 demonstrated definite improvement in scores in all groups of patients after treatment with no significant difference between the MGp and MCm group (P=0.6756) or between the FGp and FCm group (P=0.1903); however, improvement was beyond normality in comparison with control groups (P<0.00001). Conclusion Group therapy has been successfully accepted among UAE psychiatric patients, improving their fears about failure and empathy and to variable degree cognitive orientation of emotions but not anger expression.
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Clinical patterns of mood disorders in a sample of mood disorder patients in the United Arab Emirates
Mohamed Shahda, Khalid S Sherra, Hayam Fathi
September-December 2016, 37(3):148-156
DOI:10.4103/1110-1105.195545  
Background There are several conflicting findings on symptom manifestations of mood disorders in different cultures. Indeed, cultural elements appear to influence the expression of a number of secondary manifestations of the syndrome. Aim The aim of this study was to investigate the clinical presentations of mood disorders in a sample of mood disorder patients in the United Arab Emirates with reference to rural versus urban areas. Patients and methods A cross-sectional study was carried out in a sample of mood disorder patients in rural and urban areas. Nearly 300 participants were taken equally from two sites of a rural area and nearly 200 were taken equally from two urban areas. This study was carried out on a sample of United Arab Emirates population representing 65 rural (155 patients) and 60 urban (82 patients) areas. Results As regards manic symptoms, irritable mood was significantly more prevalent in the urban population, whereas disruptive behavior was more common in the rural population. As regards the symptom profile of major depressive disorders, depressed mood, lost appetite, low energy, suicidal thoughts, motor retardation, and somatic symptoms were significantly more frequent in the rural population, whereas lack of pleasure, insomnia, lack of concentration, and agitation were significantly more common in the urban population. Conclusion Retardation, somatic symptoms, low energy, and loss of appetite were more common among depressive patients of the rural population. Agitation, lack of pleasure, and insomnia were more common among depressive patients of the urban population. Both populations had nearly the same percentage in all manic symptoms, with the exception of disruptive behavior, which was more common in the rural population, and irritable mood, which was more prevalent in the urban population.
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