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   2017| January-April  | Volume 38 | Issue 1  
    Online since February 22, 2017

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Anxiety, depression, and quality of life in patients with knee osteoarthritis before and after knee joint replacement
Amr S Shalaby, Amr S El-Sayed
January-April 2017, 38(1):8-12
Aim The aim of this study was to investigate the psychological status and quality of life in a group of knee arthritis patients before and after knee joint replacement. Patients and methods A total of 26 knee osteoarthritis patients, eight women and 18 men with a mean age of 59.7±6.37 years, and 20 healthy controls, 10 women and 10 men with a mean age of 55.8±6.78 years, completed Hospital Anxiety and Depression Scale (HADS), and Short-Form 36 Health Survey (SF-36), in addition to a demographic sheet. Three months after knee joint replacement, patients refilled the same questionnaires. Results Before knee replacement, patients’ HADS scores were 10.48±3.20 and 9.60±3.41 for anxiety and depression, respectively, and except for mental health domain all other SF-36 domain scores were less than 50. After knee replacement, HADS scores became 2.36±1.52 and 4.72±1.27, and the scores of the eight domains of SF-36 became more than 50. In comparison with controls, patients showed, before knee replacement, significantly lower scores on the eight domains of SF-36, and significantly higher HADS scores. After knee replacement and except for role limitation due to emotional health and vitality SF-36 domains, patients’ scores on other domains were still significantly lower than those of controls. In spite of being within normal range, patients’ depression scores were still higher than those of controls. Conclusion Psychological status and health-related quality of life improved significantly in osteoarthritis patients 3 months after total knee replacement (TKN. The role of psychological status on patient functioning and quality of life was evident, and their improvements after surgery were parallel.
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Assessment of personality traits in a sample of opioid-dependent patients in comparison with nondependent men
Sally Mohamed
January-April 2017, 38(1):19-26
Background Drug-taking behavior and drug dependence is a multifactorial disorder. Of them, specific gene or an early established trait may act as a predisposing factor. Different environmental factors may act as precipitating and perpetuating factors, whereas individual temperament, personality, and constitutional characteristics act as the vulnerability factors. These vulnerability factors act as the causal determinants of whether or not the predispositions are expressed. Thus, personality is a very important determining factor of drug involvement. Aim of the work The aim of this study was to compare the personality profile of synthetic opioid-dependent male patients with the personality profile of non-substance-dependent male participants. Patients and methods Groups I and II were selected consecutively and were recruited from Kasr El-Aini Hospital as well as private hospitals in greater Cairo during the period from November 2012 to March 2013. Group I included 30 substance-dependent male patients and group II included 30 non-substance-dependent male participants who were subjected to personality assessment schedule; the addiction severity index was applied only to group I. Results The sociodemographic findings of the study found that 80.0% of patients in group I were not working due to substance dependence and only 20% were working, whereas in group II 90% of participants were working and only 10% were not working. An overall 66.7% of patients in group I were divorced and only 26.7% were married, whereas in group II one was divorced and 86.7% were married. As regards the personality test, 73.3% of patients in group I had severe degree of the sociopathic trait, 20% has sociopathic trait difficulty, and only 6.6% did not have sociopathic trait. Conclusion Our study showed the effect of opioid dependence in changing behavior and personality traits, emphasizing that diverse maladaptive personality traits and these negative traits are the familial risk factors for substance use disorders. They act as a predisposing vulnerability and predict the onset or age of expression of substance-related problems and tendency to relapse. Impulsive–aggressive personality traits in childhood and adolescence predict early onset of substance abuse.
  3,173 182 2
Sleep problems among adolescents: is there a relation with deliberate self-harm and aggression?
Youmna Sabri
January-April 2017, 38(1):1-7
Background Adequate sleep during adolescence is important for healthy development and proper daytime functioning. Sleep problems are commonly reported in adolescents, with an estimated prevalence between 17 and 45%. Besides, adolescence period is usually associated with various behavioral problems such as aggression and self-harm. Aims The aim of this study was to evaluate sleep habits and the presence of sleep problems in an Egyptian adolescent sample. Moreover, this study aimed to examine the presence of a relationship between sleep problems and the development of aggression and self-harm among those adolescents. Patients and methods A total of 117 adolescents in the preparatory stage participated in this study. Three self-report questionnaires were used, Child and Adolescent Sleep Checklist, the Deliberate Self-Harm Inventory, and the Aggression Scale, for students for assessment of sleep problems, deliberate self-harm (DSH), and aggression, respectively, among those adolescents. Results A total of 117 adolescents, 51 (43.6%) male and 66 (56.4%) female, participated in this study; their mean age was 13.85±0.81 years. Bedtime problems and daytime problems are more common among adolescents, with higher scores (8.10±3.99 and 6.56±3.61, respectively). Of those, 36 (30.8%) adolescents had a score of 18 or more, and so they were considered to have sleep problems. The participated adolescents had score ranging from 3 to 38 in the Aggression Scale, with a mean±SD of 12.36±8.32. A total of 24 (20.5%) adolescents had engaged in self-harm according to the Deliberate Self-Harm Inventory. Moreover, a significant positive correlation (P<0.001) was found between sleep problems and both DSH and aggressive behaviors among those adolescents. Conclusion Bedtime problems and daytime problems were common among the participated adolescents. Moreover, DSH and aggressive behaviors were reported. This study provides evidence that there is a strong relationship between sleep problems and both DSH and aggressive behaviors among those adolescents. Early detection, diagnosis, and treatment of sleep problems and promoting sleep hygiene will, undoubtedly, improve adolescents’ daily functioning and will have good impact on controlling these annoying behavioral problems.
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Longitudinal effect of depression on glycemic control in patients with type 2 diabetes: a 3-year prospective study
Hesham Abuhegzy, Heba Elkeshishi, Noha Saleh, Khaled Sherra, Ali Ismail, Ahmed Kamel, Khaled Abd El Azim, Dalia Khalil
January-April 2017, 38(1):27-34
Objectives The aim of this study was to examine the longitudinal effect of depression on glycemic control in a sample of patients with type 2 diabetes. Patients and methods Patients were recruited from the diabetes clinic in Saudi Airlines Medical Centre, Jeddah; the baseline study community consisted from 172 patients with type 2 diabetes. They were assessed for depression using Beck Depression Inventory-II and a diagnostic interview and for diabetic control using HbA1c. We created a person–period dataset for each patient to cover 6-month intervals up to 3 years. We used the generalized estimation equation (GEE) for the analysis of longitudinal data. HbA1c was the response variable, whereas depression and time were the main covariates. Variables were included in GEE models based on clinical importance and preliminary analysis. Other variables included as covariates were sex, education, duration of diabetes, comorbidity, and Low-density Lipoprotein (LDL). All statistical analyses used an α-value of 0.05 as the level of significance and were performed using SPSS software version 21. Results Unadjusted HbA1c means were significantly higher in depressed as against nondepressed individuals at all time points. Adjusted HbA1c means in the final GEE model were significantly higher in depressed as against nondepressed individuals. In all adjusted models, depression was a significant predictor of glycemic control, whether it was measured as the Beck Depression Inventory score (estimate=0.049, P=0.002) or diagnoses of major depressive disorder (estimate=2.038, P=0.000) or other depressive disorders (estimate=1.245, P=0.000). Conclusion This study on a clinical sample of type 2 diabetic patients demonstrates that there is a significant longitudinal relationship between depression and glycemic control and that depression is associated with a persistently higher HbA1c over time.
  2,643 262 2
Distress among parents of attention-deficit/hyperactivity-disorder children: relationship with children’s symptom severity and behavioral disturbances
Mohamed A Abdelhameed, Maha A Hassan, Nashaat A.M. Abdel-Fadeel
January-April 2017, 38(1):49-58
Background The symptoms and behaviors of children with attention-deficit/hyperactivity-disorder (ADHD) impose demands and difficulties on the part of their caring parents that may cause the latter group to suffer psychological stress. Aim and objective The aim of this work was to study the type and severity of symptoms in children with ADHD and their effect on the parents. Patients and methods Thirty-seven children with ADHD who were diagnosed clinically and using the Conners test were studied using the Child Behavior Checklist. The available parent for each child was interviewed and studied with the Symptom Checklist 90 Revised. Two control groups were used for both ADHD children and their parents. Results The mean age of the children with ADHD was 7.1±1.6 years. There were 22 male and 15 female patients. Parents of these children scored high on total and subscales of the Symptom Checklist 90 Revised. The scores were significantly higher than that in the control group on total and some of these subscales, including somatization, interpersonal, depression, paranoid ideation, and hostility domains. Depression and paranoid ideation of ADHD children parents were positively and significantly correlated with most of the subitems of the Conners test of their children. In addition, somatization, depression, and hostility of parents were positively and significantly correlated with most of the subitems of the Child Behavior Checklist of their ADHD children. Conclusion Symptoms, behaviors, and severity of illness of children with ADHD have a great impact on their parents’ psychological state, suffering, and distress.
  2,673 223 -
Behavioral and psychological characteristics of patients with different types of dementia in Mansoura, Egypt
Hanan Elsayed, Ibtihal M. A. Ibrahim, Mohammad Abu-Hegazy, Mostafa Amr
January-April 2017, 38(1):13-18
Objective This study aimed to describe the behavioral and psychological symptoms of patients with different types of dementia and to correlate these symptoms to demographic and clinical variables of dementia such as age, sex, and score of cognitive assessment scales. Patients and methods This study was carried out on 73 patients with dementia. Patients were classified into three groups: patients with Alzheimer dementia, patients with vascular dementia, and patients with mixed dementia. Cognitive evaluation of the three groups was performed by the Mini Mental State Examination and Clock Drawing Test. The neuropsychiatric inventory was used to assess behavioral and psychological symptoms. Daily activities were assessed using Activities of Daily Living and The Lawton Instrumental Activities of Daily Living. Results Apathy depression, and sleep disturbances were most prevalent in Alzheimer dementia, whereas depression, anxiety, and apathy were most prevalent in vascular dementia and in the miscellaneous group. There was a highly statistical difference between the three groups as regards depression and anxiety (P≤0.0001). Duration of illness correlated negatively with the scores of Mini Mental State Examination (P<0.001), Clock Drawing Test (P<0.001), Activity of the Daily Living (P<0.001), and the Lawton Instrumental Activities of Daily Living scores (P=0.003). Severity of the symptoms was higher in the miscellaneous group of dementia and lower in the Alzheimer group (P<0.001). Conclusion Apathy, depression, anxiety, and sleep disturbances were the most prevalent psychiatric symptoms. The severity of the symptoms was lower in the Alzheimer group and worse in the miscellaneous group. There was a positive correlation between the cognitive function and the functionality of those patients.
  2,260 206 -
Early-onset versus late-onset obsessive–compulsive disorder: an immunological comparative study
Sahar El Emam Gad, Wafaa Mohamed El Emshaty, Hanan El-sayed Hussein, Osama Ahmed El-Boraie, Mohammed Ali Ezzat El-Hadid
January-April 2017, 38(1):41-48
Objectives This study was conducted to investigate the possible role of streptococcal infection in obsessive–compulsive disorder (OCD) and to clarify whether the age of onset could affect its clinical presentation and immunological results. Participants and methods The study was carried on 96 participants. They were divided into 46 OCD patients with a mean age of 30.76 years and 50 healthy controls with a mean age of 28.94 years. The patients group was subdivided according to the age of onset into the early-onset group include 21 patients with onset age of 18 years or less and the late-onset group include 25 patients with onset age above 18 years. All participants were subjected to psychometric and serological assessments of serum antibasal ganglia autoantibodies (ABGA) and antistreptolysin O titer (ASOT). Results Rates of ABGA positivity were 26.1% in the OCD group compared with 30% in the control group, with no significant difference (P=0.670). ASOT positivity were 6.5% in the OCD group, whereas none of the controls had positive ASOT (P=0.160). Positivity for ASOT and ABGA was not associated with the age of onset as 95.2 and 71.4% of the early-onset group had positive ASOT and ABGA results against 92 and 76% in the late-onset group, respectively, with no significant differences (P≥0.05) or clinical variables. Positivity for ASOT was not associated with ABGA positivity. Conclusion The negative results of this study do not exclude the role of autoimmunity in OCD pathogenesis. Further investigations are needed to establish this role.
  2,153 151 1
An observational study of the characteristics of different substance-use disorder subtypes combined with adult attention deficit hyperactivity disorder
Khaled S Sherra, Dalia M Khalil, Ahmed M El Melegy
January-April 2017, 38(1):35-40
Aim The aim of this study was to examine the characteristics and intensity of the association between various subtypes of substance-use disorders (SUD) with adult attention deficit hyperactivity disorder (ADHD) and compare this with the progression of substance use in those without ADHD. Participants and methods The study was conducted at the Psychiatric Department, Mansoura University Hospital. Both inpatients and outpatients who screened positive for any one of the substances such as alcohol, opioids, amphetamine, or cannabis were approached to enter the study. Out of these, patients who gave informed consent, satisfied the inclusion and exclusion criteria, and met the DSM-IV-TR diagnosis for SUD for dependence or abuse entered the study and completed the patient intake form. A total of 100 such consecutive patients were screened for symptoms of adult ADHD by administering the first six questions of part A of the Arabic version of the adult ADHD self-report scale-VI.I (ASRS-VI.I) symptom checklist. Only the first six questions that are found to be the most predictive of symptoms were included for screening. Patients who answered positive for four or more questions were further interviewed using the Diagnostic Interview of Adult ADHD to make a diagnosis of adult ADHD in these patients. A total of 97 patients completed all parts of study questionnaire. The patients were divided and grouped depending on the type of substance abused, alcohol, opioid, cannabis, amphetamine, or polysubstance, and whether or not they had comorbid adult ADHD. The results obtained were statistically analyzed using SPSS software. Results The prevalence and course of SUD combined with adult ADHD differed depending on the primary substance of abuse. Cannabis and alcohol users had a higher percentage of adult ADHD (36.4 and 33.3%, respectively) compared with other drug users. Cannabis had the earliest age of onset of SUD at 15 years of age. Cannabis and amphetamine had a prolonged duration of abuse: 14.87 and 14.7 years, respectively. Similarly, they had a greater number of hospitalizations (3.82 and 3.88 times, respectively) and an increased duration of stay in the hospital (166.67 and 110 days, respectively) as compared with other drugs. Polysubstance, cannabis, and amphetamine abusers had more relapses: 3.27, 3.36, and 3.38 times, respectively. Conclusion The percentage of ADHD differs among different subgroups of SUD depending on the primary substance of abuse. Cannabis and amphetamine have a higher comorbidity, an earlier age of onset, and a more protracted course of SUD in ADHD patients compared with other drugs.
  1,919 151 -