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  Citation statistics : Table of Contents
   2019| January-April  | Volume 40 | Issue 1  
    Online since May 9, 2019

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Assessment of sexual dysfunction in females with systemic lupus erythematosus
Hani H Dessoki, Ahmed A Moussa, Hisham Salah, Yasmeen A Noor
January-April 2019, 40(1):1-4
Introduction Sexual dysfunctions are common sexual health problems affecting a substantial proportion of females with systemic lupus erythematosus (SLE). Objective This study aimed at the evaluation of female sexual dysfunction in patients with SLE. Materials and methods A total of 50 females with SLE and 50 matched healthy female volunteers were assessed using the Arabic version of Female Sexual Function Index. Married and sexually active females during the past 6 months with established diagnosis of SLE were recruited from the Rheumatology Clinic, Beni-Suef University hospital during the period from March to August 2017. All data were statistically analyzed using the IBM statistical package for the social sciences version 20. Results The study showed that 60% of females with SLE and 16% of healthy controls reported abnormal sexual function according to the FSFI total scores, with a statistically significant differences in-between (P=0.00). Conclusion Female sexual dysfunction is a common problem among patients with SLE.
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White matter hyperintensities in elderly patients with late-onset and early-onset depression: a comparative study
Abdelhamid H Hashem, Hashem Mohamed Nasreldin, Maged A Gomaa, Ola O Khalaf, Ayman Ismail
January-April 2019, 40(1):17-23
Background Depression in late life is associated with subtle irreversible cognitive impairment, subtle structural brain damage, and a high frequency of white matter and other lesions, on visualization with MRI. Objectives The objective of this article is to explore the role of white matter hyperintensities (WMH) in elderly patients with depression. A total of 80 elderly patients with depression were recruited from the Geriatric Outpatient Clinic of Psychiatry and Addiction Prevention Hospital, Kasr Al-Ainy, Cairo University. They were divided into two groups according to the age of onset of depression: late-onset group [late-onset depression (LOD)] and early-onset group (early-onset depression). Patients and methods This was a hospital-based, cross-sectional, comparative study with consecutive referral. The patients were subjected to MRI of the brain to assess WMH using modified Fazekas score, Hamilton depression rating scale, and Addenbrooke’s cognitive examination revised. Results The mean total score of modified Fazekas score is significantly higher in the LOD group than in the early-onset depression group, and the periventricular WMH are significantly higher in the LOD. Conclusion WMH are more associated with LOD in elderly patients.
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Cognitive and psychological evaluation of a sample of egyptian patients with behcet’s disease without neurological manifestations: a case–control study
Sonya M Rashad, Essam A.M Abda, Romany H Gabra, Mohamed R.A Razek, Tarek Desoky, Esraa A Talaat
January-April 2019, 40(1):24-30
Objective Behcet’s disease (BD) is a chronic autoimmune multisystemic vasculitis of unknown cause that affects one case per 170 000 persons in the USA. There are few studies in the literature that targeted BD patient group for cognitive and psychological evaluation and scarce studies that evaluated the patients with BD without neurological manifestations. In this study, we aimed to assess those who have BD without neurological manifestations for cognitive and psychological impairments. Patients and methods A case–control study was conducted. A total of 45 consecutive adult patients, aged 18–60 years, diagnosed with BD without neurological manifestations were evaluated for cognitive and psychological impairments and compared with 30 age-matched and sex-matched healthy control participants. Detailed clinical evaluation was done including disease activity measurement using Behçet’s Disease Current Activity Form. Participants completed a group of neuropsychological assessment including Memory Assessment Scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Short Form 36 Quality-Of-Life questionnaire, and Global Assessment of Functioning scale. Results Compared with the control group, patients with BD scored lower in Memory Assessment Scale (total and subscores), Short Form 36 Quality-Of-Life questionnaire, and Global Assessment of Functioning scores. BD group showed significantly higher prevalence of depression and anxiety. Conclusion BD without neurological manifestations was associated with cognitive and psychological impairment, and this was not restricted to cases with neuro-BD.
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Executive dysfunction in an Egyptian sample of adult participants with epilepsy: a case–control study
Tarek Desoky, Romany H Gabra
January-April 2019, 40(1):31-34
Objective The present study aimed to detect the executive function deficits that may affect patients with idiopathic epilepsy and the factors that influence such affection. Study design A case–control study was conducted. Materials and methods A total of 40 adult patients aged from 20 to 50 years, with idiopathic epilepsy recruited from the outpatient clinic of South Valley and Assiut University hospital and a similar number of age-matched and sex-matched controls were included. Participants completed Wechsler Intelligence Scale and neuropsychological tests including Wisconsin card sorting test, trail making test (trails A and B), Conners’ continuous performance test, and digit span tests. Results Relative to the control group, patients poorly performed on most of executive functions, with the longer duration of illness and the higher frequency of seizures being the most evident factors that showed a positive correlation with the executive dysfunction. However, age at onset, type of seizures, and family history of epilepsy had no significant correlation on neuropsychological test performance. Conclusion One of the main domains of evaluation of the patients with chronic epilepsy should be the cognitive domain. A large number of studies shed light on such hypothesis. Executive dysfunction in patients with epilepsy may share negatively in their quality of life, so it should be a target of diagnosis and therapy.
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Serum uric acid level and its association with severity of manic and depressive symptoms
Hani H Dessoki, Maha Emadeldin, Ahmed A Ezzat, Hisham Salah, Sarah M Hakim
January-April 2019, 40(1):35-40
Background Prior reports pointed out that individuals having bipolar disorder (during manic episodes) and those with major depressive episode might have changes in their serum uric acid (SUA) levels. The aim of the study was to investigate SUA levels in patients with bipolar I (current manic episode) and major depressive disorders (MDDs) compared with healthy controls. Participants and methods A cross-sectional case–control study with consecutive sampling of 90 participants was conducted. Psychiatric assessment for all participants was performed using the Structured Clinical Interview for DSM IV-TR Axis I Disorders, Arabic version (SCID I). Young mania rating scale and Hamilton depression rating scale were introduced to patients with bipolar disorder I and MDD, respectively, to assess the illness severity. Blood samples were obtained through venipuncture after overnight fasting from 10 to 12 h. Results SUA showed significant higher levels in bipolar disorder group (mean=5.95±0.55) than MDD group (mean=3.36±0.66) and controls (mean=4.54±0.65, P=0.00). On the contrary, SUA revealed a statistically significant lower level in MDD group than controls (P=0.00). There is no significant correlation between SUA levels and severity of current manic and depressive symptoms (P=0.44 and 0.80, respectively). Conclusion SUA levels were significantly higher in patients with manic symptoms than in patients with depressive symptoms and controls. There is no significant association of SUA and severity of manic or depressive symptoms.
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Defense style and dissociative phenomena in patients with borderline personality disorder
Mohamed A Abdelhameed, Mohamed T Seddik, Nashaat A.M Abdel-Fadeel
January-April 2019, 40(1):41-47
Introduction Patients with borderline personality disorder (BPD) are unique and diverse in their pathology, defense style, and clinical presentations. Many of these patients have other personality disorders as well. They tend to display a wide range of other psychiatric disorders, including dissociative phenomena and experiences. Patients and methods A total of 60 female patients were diagnosed with BPD using the Diagnostic and Statistical Manual of Mental Disorders, IV ed. Structured Clinical Interview for DSM-IV Axis II Personality Disorders. Severity of illness and emotional and behavioral aspects of patients were assessed using Borderline Evaluation of Severity over Time. Defense style of patients was assessed using the Defense Style Questionnaire. Dissociative phenomena were studied using the Dissociative Experience Scale (DES). Results The most commonly used defenses by the study patients were undoing, idealization, somatization, and splitting. Patients with absent criteria 4 (impulsivity) and 7 (feeling of emptiness) of BPD significantly displayed more mature defenses, whereas patients having criterion 9 (paranoid ideation and severe dissociation) of BPD significantly displayed neurotic type of defenses. Mature defenses were significantly negatively correlated with the absorption and depersonalization factors of DES. Neurotic defenses were significantly correlated with the total score of DES, absorption, and depersonalization factors. Immature defenses were significantly correlated only with the depersonalization factor of DES. Conclusion Patients with BPD have a specific pattern of defense style that might be linked to their specific illness criteria. Displaying certain phenomena of dissociation might be related to the particular pattern of the dominant defense mechanisms in these patients.
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Insight and its clinical correlates in a sample of hospitalized psychotic patients
Nashaat A.M Abdel-Fadeel
January-April 2019, 40(1):48-57
Background Insight is a complex phenomenon including many dimensions, such as insight about the illness, about need for treatment, and about consequences of having that illness. Assessment of insight in psychiatric patients is important as it is implicated in the course of illness, adherence to treatment, and prognosis. Objective The aim was to evaluate the level of insight in schizophrenia spectrum disorders and also in bipolar and major depressive disorders with psychotic features and to examine the relationship between level of insight and sociodemographic and illness-related characteristics, including severity of symptoms. Patients and methods A total of 85 patients diagnosed with schizophrenia spectrum disorders (group 1) and 44 patients diagnosed with bipolar disorder with psychotic features and major depressive disorder with psychotic features (group 2) who were admitted to Minia Psychiatry Hospital in a period of 6 months were included in the study. Diagnosis was done using Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-5 research version. Level of insight was assessed using Scale to assess Unawareness of Mental Disorder assessing awareness of mental disorder, awareness of the need for treatment and awareness of social consequences of mental disorder. Severity of symptoms and psychopathology was assessed using Positive and Negative Syndrome Scale and Clinical Global Impression Scale (CGI). Results Patients diagnosed with schizophrenia spectrum disorders (group 1) tended to have poorer insight than those with bipolar affective disorder (BAD) and major depressive disorder (MDD) with psychotic features (group 2) on admission and also on discharge. Levels of insight of both groups differed significantly on discharge when compared with their levels of insight on admission, but that difference was more profound in group 2. Stepwise multiple linear regression analysis predicting level on insight revealed that blunted affect, lack of judgment and insight, conceptual disorganization, and CGI severity of illness were the most implicated factors in determining insight on admission whereas CGI efficacy index, grandiosity, motor retardation, and passive/apathetic social withdrawal were factors determining insight on discharge. Conclusion Patients diagnosed with schizophrenia spectrum disorders have poorer insight than those diagnosed with BAD and MDD with psychotic features. Predictors of insight differ on admission than on discharge.
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Sleep patterns among bipolar disorder patients
Hussein E El Sheikh, Hisham M El Sayed, Shewikar T El Bakry, Asmaa A. Abd El Hamed
January-April 2019, 40(1):5-16
Background Bipolar disorder (BD) is a lifelong, potentially treatable psychiatric disorder with substantial morbidity and mortality. Sleep is a very important factor for the quality of life, risk for relapse, affective functioning, cognitive functioning, impulsivity, and general health. It is important to note that a bidirectional relationship likely exists between sleep disturbance and mood disorders, as symptoms of mood disorders may disrupt sleep, and disrupted sleep can increase symptoms of mood disorders. Moreover, the sources of inflammation and immune activation, which play a role in depression, may contribute to the inflammatory burden in patients with mania. Aim The aim of this study was to study the nature of sleep disturbance in bipolar patients and to detect the correlation between the severity of BD and sleep disturbance. Patients and methods In this case–control study, fifty BD patients (28 male patients and 22 female patients) and 20 age-matched controls were recruited for this study. Structured Clinical Interview for DSM-IV Axis I Disorders for diagnosis of BD; Beck Depression Inventory-II and Young Mania Rating Scale (YMRS) were used to assess the severity of BD. Assessment of sleep pattern was carried out by Pittsburgh Sleep Quality Index (PSQI), and C-reactive protein (CRP) was measured. Results In the current study, with regard to Beck scores before medication, there were inverse relations with YMRS and PSQI. These relations become direct after medication. As regards YMRS scores before medication, there was an inverse relation with Beck, direct relations with PSQI, which did not show any change after medication, except for sleep disturbance, which become an inverse relation. As regards PSQI’s total scores before medication, it showed an inverse relation with Beck, direct relations with YMRS and the relation with Beck scores became direct after medication. As regards CRP levels, there was a significant difference between cases before and after medication and significant difference between the case and control groups. Conclusion PSQI is a cheap valid test that can be used in Egypt to report sleep profile and abnormalities, to follow-up the patients and prevent relapse. Hence, bipolar patients with depressive symptoms improved and responded better on treatment, with better improvement in sleep profile than patients with manic symptoms. Moreover, a definite correlation between sleep disturbance and CRP levels could not be concluded.
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