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   2021| May-August  | Volume 42 | Issue 2  
    Online since July 2, 2021

 
 
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ORIGINAL ARTICLES
Depression, anxiety, and quality of life in patients undergoing hemodialysis and renal transplantation
Mohamed Nasreldin, Nagwan Madbouly, Sahier El-Khashab, Ibrahim Sehsah, Mohamed Ghallab, Mohammed Moneer, Hend Habiba, Mohamed T Eldin, Shirin El-Makawi
May-August 2021, 42(2):69-77
DOI:10.4103/ejpsy.ejpsy_45_20  
Background End-stage renal disease (ESRD) is a severe and debilitating disease. Insignificant data exist on depression, anxiety, quality of life (QoL), and life satisfaction in patients on hemodialysis (HD) in comparison with patients with renal transplantation (RT). Aim The aim of this study was to compare the presence and severity of depression and accompanying anxiety symptoms between HD patients and RT recipients and to correlate both depression and anxiety with the QoL and life satisfaction affection in both groups of patients. Patients and methods A comparative cross-sectional study was conducted on 64 patients with ESRD who were recruited consecutively from the nephrology outpatient clinic of Kasr Al Ainy, Cairo University Hospitals, over a period of 1 year. Patients were applied the Physical, Cognitive, Affective, Social, Economic and Ego Questionnaire to assess QoL, Beck Depression Inventory to assess depression, Middlesex Hospital Questionnaire to assess anxiety, and Life Satisfaction Scale for life satisfaction. Results The study results showed that depression, anxiety, and somatization in the HD group showed significant higher scores than the RT group. Patients on HD were significantly less satisfied with their life and showed lower scores on the physical domain, whereas patients with RT had significant lower scores on the economic domain of QoL. Life satisfaction and most domains of QoL were negatively correlated with depression, anxiety, and somatization in the HD group. Conclusion Depression accompanied with a variety of anxiety symptoms constituted determinants of poor QoL in the setting of ESRD and consequently, less life satisfaction. HD patients showed higher levels of depression, anxiety, and somatization along with poorer QoL and less life satisfaction than patients with RT.
  877 96 -
The effect of COVID-19 pandemic on the mental wellbeing and coping strategies of health care providers in Kasr Al-Ainy Hospital
Mostafa O Shahin, Mai A Samie, Sandra W Elseesy, Nehal Mostafa, Kyrolos M Meshreky, Doaa R Ayoub
May-August 2021, 42(2):93-99
DOI:10.4103/ejpsy.ejpsy_39_20  
Objective The pandemic of coronavirus 2019 (COVID-19) in Egypt has represented a distinctive threat in terms of psychological distress for health care providers. The first studies on the effect of the COVID pandemic on health care professionals were developed in China, but with the spread of the pandemic, other countries started to conduct studies analyzing the psychological response of health care workers to the pandemic. This study aims to investigate the mental well-being in terms of depression and anxiety, coping strategies, along with quality of life (QoL) among health care providers working in Kasr Al-Ainy Hospital during the COVID-19 outbreak. Patients and methods Self-administered questionnaires were distributed online through Google forms to health care providers (N=108) working in Kasr Al-Ainy Hospital from beginning of June to end of August 2020. The questionnaires measured depression, anxiety, coping strategies, QoL, and COVID-19 exposure among Egyptian health care providers. Results Overall, ∼40% of health care providers in our study were directly involved in the management of patients infected with COVID-19. They showed higher mean Beck Depression and Beck Anxiety Inventories total scores. Participants perceived their current mental health to be worse during the COVID-19 pandemic as compared with before the outbreak. Conclusions Both immediate-term and long-term psychiatric services for health care workers in Kasr Al-Ainy Hospital should be implemented to re-establish psychological well-being and enhance QoL and resilience for them during times of severe distress.
  853 87 -
Suicidal behaviors among patients with tramadol dependence in a sample of Egyptian population
Sara Mehrez, Osama Elboraie, Warda Abo Elez, Mohamed El Wasify
May-August 2021, 42(2):78-83
DOI:10.4103/ejpsy.ejpsy_48_20  
Background Suicidal behaviors are a major health problem in opioid-dependent patients. Tramadol is one of the most abused substance in Egypt, presenting a public burden and associated with higher morbidity and mortality. This study aimed to look for suicidal ideation, suicidal attempts, and nonsuicidal self-injurious behavior among patients with tramadol dependence. Patients, methods, and results This study included 120 participants (60 for patient with tramadol dependence and 60 for comparative group). Participants were assessed using the Structured Clinical Interview (SCID-I), (SCID-II) according to the Diagnostic and Statistical Manual, fourth edition; Addiction Severity Index; and Columbia-Suicide Severity Rating Scale. Suicidal ideation was detected in 38.3% of tramadol cases and 13.3% in comparative group (P=0.001). Suicidal behaviors were reported in 26.6% of cases and 6.6% in comparative group (P=0.003). Conclusions Suicide is common in patients with tramadol dependence and is associated with severity of addiction.
  865 74 -
Personality traits and its relation to craving and serum oxytocin among male patients with opioid dependence
Maha W Mobasher, Heba F Eid, Aliaa M Soliman, Hadeel M El-Hanafi, Shaden Adel, Noha A Mahfouz, Shirin M El-Makawi
May-August 2021, 42(2):59-68
DOI:10.4103/ejpsy.ejpsy_44_20  
Background As craving is one of the main problems that affect substance users and their progress during treatment, it was important to investigate personality traits that affect it. Although oxytocin (OT) system is regarded as being of relevance for social interaction, very few studies have investigated the relationship between OT and personality traits in clinical psychiatric populations. Objectives The aim of the work is to assess the personality traits among patients with active opioid dependence in comparison with abstinent patients and healthy controls and to assess the relation of personality traits with the degree of craving and serum OT level. Patients and methods A consecutive sample of 30 opiate-dependent patients who fully meet the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria for opiate dependence and 30 patients fulfilling the DSM-V criteria of opiate dependence with at least 6 months of abstinence were assessed regarding personality traits, serum craving levels, and OT levels using Personality Inventory for DSM-brief form, brief substance craving scale, and immunoassay kit, correspondingly. They were compared with each other and with a sample of 30 healthy controls matching both groups. Results Total personality dysfunction scores were statistically significantly higher in the patient group than the control group (P<0.001) and the abstinent group (P<0.05). There was no statistically significant difference between the abstinent group and the control group. A positive correlation was found between craving and total personality dysfunction (P<0.001) as well as each of the five traits [negative affect (P<0.05), detachment (P<0.001), antagonism (P<0.05), disinhibition (P<0.001), and psychoticism (P<0.05)]. Craving levels showed a statistically significant difference between the patient group and the abstinent group (P<0.001). There was a statistically significant difference between the patient group and the control group in serum OT levels (P<0.05). The correlation between personality dysfunction and serum OT level in the patient group was not significant. Conclusion The interaction between personality traits, craving, and serum OT levels should be considered when dealing with opiate-dependent patients as they affect and are affected by opiate dependence. Further studies regarding how to implement this during the patient’s treatment should be considered.
  822 74 -
Effect of lifestyle modification on schizophrenia patients on antipsychotics
Nagda M Elmasry, Eman F Ali, Rofaida M Abdelmoez
May-August 2021, 42(2):100-107
DOI:10.4103/ejpsy.ejpsy_40_20  
Background Schizophrenia affects physical health, represented in the form of change in behavior, such as decrease in physical activity, tendency to isolation, and changes in eating behavior, including increase intake of food (junk food and fat) and increase in consumption of sugar. Patients with schizophrenia tent to increase consumption of cigarettes and caffeine. All of these contribute toward having a bad effect on physical health, as they increased the risk of occurrence of comorbid diseases, such as hypertension, diabetes mellitus, and metabolic syndrome (MetS). Although there is treatment for schizophrenia, it has serious adverse effects, including sleepiness and slowness, weight gain, interference with sex life, and increased chance of developing diabetes and hypertension. Patients and methods A total of 36 patients underwent programmed lifestyle modification, which include pharmacological intervention and lifestyle interventions, including psychoeducational, dietary, and exercise programs. The psychoeducational program focused on the roles of eating and activity in weight management. Dietary program included individualized well-balanced diet plan for each patient by a clinical nutritionist in the hospital according to patient’s measurements, physical health, and acceptance. Exercise program included aerobic exercise intervention and stretching-toning control program, which was planned by the physical trainer of the hospital in the playground. Assessment is done at the beginning of the study and monthly through 3-month duration. We used Positive and Negative Syndrome Scale to assess and follow-up symptoms of schizophrenia, GASS for follow-up of adverse effects of antipsychotics, and Health Promoting Lifestyle Profile Scale II to detect the effect of lifestyle modification. Results The mean age of the studied group of patients was 34.5±5.87 years, with 56.41% of them being male. Overall, 25% of patients were found to have MetS at the beginning of the study, and after 3 months of commitment to the program of lifestyle modification, they decreased to 16.67%. There was a significant difference between the studied participants regarding metabolic parameters throughout the 3 months. There was significant improvement in all other dimensions of Positive and Negative Syndrome Scale and significant improvement in total GASS scale after the second months of commitment of lifestyle modification, with significant improvement in all dimension except for cardiovascular and screening for diabetes. Conclusion Schizophrenia and antipsychotics have an effect on lifestyle of the patients, leading to more exposure of them to medical comorbidities such as hypertension, diabetes mellitus, and MetS, and it also effects the sedentary life, diet, and smoking. This can be avoided by applying a lifestyle modification program that targets to improve quality of life, symptoms of schizophrenia, and decreased number of relapses by increasing adherence to treatment.
  662 69 -
A cross-sectional study of risk factors for postpartum depression
Hiame F El Saied, Ahmad Eissa, Taghread S El Kholy
May-August 2021, 42(2):108-114
DOI:10.4103/ejpsy.ejpsy_10_17  
Background Postpartum depression (PPD) is found across the globe, with rates varying from 11 to 42%. Several key risk factors have been identified as major contributors to the development of PPD. Objective The aim of the present study was to assess the sociodemographic and clinical characteristics of PPD and to delineate risk factors for PPD to guard against recurrence and to get a hope for prophylaxis. Patients and methods In this cross-sectional study, 60 PPD females were diagnosed from among 230 Arabic-speaking consenting consecutive postpartum females who were referred from Department of Obstetrics and Gynecology at the Maternity and Child Hospital at Al Medina Al Monawara (Kingdom Saudi Arabia), from January 2015 to June 2015 and underwent complete psychiatric examination with stress upon demographic data and clinical characteristics of the patient using the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision classification. Obstetric case sheets were prepared and psychometric studies were carried out using an Arabic version of the Edinburgh postnatal depression scale, life event questionnaire, and social class study. Results In the current study PPD was diagnosed in 60 out of 230 (26%) postpartum females with a mean score of Edinburgh postnatal depression scale of 13.4±2.3 between the first and second months postpartum in 53.3%, was more common in the young age group, with a past history of psychiatric illness, was more prevalent in rural areas with low social class and social support, more in those with unwanted pregnancies and difficult labor and puerperium. PPD was precipitated by various stressors. Conclusion The current study revealed many risk factors contributing to PPD among females at Al medina Al Monawara, Kingdom Saudi Arabia. Recommendation Encouraging the liaison link between the psychiatric and obstetrics and gynecology doctors together with social workers could help in guarding against recurrence and to get a hope for prophylaxis.
  546 61 -
Association of angiotensin-converting enzyme gene polymorphism and clinical characteristics in Egyptian patients with major depressive disorder
Adel ElMissiry, Fatma A Abuzahra, Marwa ElMissiry, Eman Shorub, Reem Hashim, Dalia A.M Mahmoud
May-August 2021, 42(2):84-92
DOI:10.4103/ejpsy.ejpsy_49_20  
Objectives Depression is one of the leading causes of disability and suicide worldwide. It has strong genetic etiopathogenesis, especially that related to angiotensin-converting enzyme (ACE) gene polymorphism. Therefore, this research tackled the relation between genetic variants of ACE polymorphism and symptomatology profile of major depression. Patients and methods A total of 42 patients diagnosed with depression matched with 39 controls underwent Structured Clinical Interview for the DSM-IV Axis I diagnosis clinician version, Structured Clinical Interview for the DSM-IV Axis I diagnosis-nonpatient edition, Hamilton Depression Rating Scale, real-time PCR for genotyping, and serum cortisol level assay. Results ACE I/D gene polymorphism was significantly higher in patients with major depression (45.2%) compared with the control group (25.6%). Patients with I/D polymorphism showed longer duration of illness; greater severity; higher number of episodes and rate of hospitalization; higher tendency to be prescribed serotonin/norepinephrine reuptake inhibitors and to receive electroconvulsive therapy; higher scores of core depressive symptoms, such as guilt feeling, inability to work, and suicidal ideation; and higher serum cortisol level than the other genotype groups. Conclusion Our findings support the notion that ACE I/D polymorphism affects major depression severity and symptomatology imprint.
  404 51 -