AJP-Vol. 6, N° 1, May (1995)

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THE ARAB JOURNAL OF PSYCHIATRY Vol. 6, N° 1, May (1995) E.mail: takriti@nol.com.jo

q CONTENTS / SOMMAIRE / فهرس الموضوعات
q Editorial § The Future of the Arab Journal of Psychiatry / Tewfik K. Daradkeh, Mohammad T. Abou-Saleh q Review § Tired and Depressed or just Tired. A Review of Psychiatric Morbidity Associated with Chronic Fatigue Syndrome / Janis Hillier & Anne Farmer q Views § Cultural Aspects of Illness Behaviour / M.Fakhr El-Islam q News § The Arabic Composite International Diagnostic Interview (CIDI) / Karam EG,Yabroudi P.Nasser Karam A.Mansour C.Sabah S&AI Atrash R. q Original Articles § The Diagnostic Values of Cortisol Suppression Test and Dexamethasone Suppression test in Depression / M.T Abou-Saleh, J. Collins & A. George § Schneider's First-rank Symptoms of Schizophrenia in an Arab Patient Population : Their Prevalence and Diagnostic Validity / Tawfik K Daradkeh , Emad Hamdi , Yousreya Amin § The Positive - Negative Distinction In Schizophrenia : Is it Sufficient ? / Halim Z., MoussaS., Abd El Gawad T.,El Bakry A.,El Batrawi M.,Askar M. § Gender Differences in Psychiatric Admissions : The Influence of Culture and Social Structure / Yousreya Amin & Emad Hamdi · Referrals by General Practitioners to a Primary Health Care Psychiatric Clinic - diagnostic Status and Sociodemographic characteristics. / Omer E. F. El-Rufaie · WHO / DAS or APA / GAF . A Difficult Choice / Tawfik K. Daradkeh & A. Saad · Depressive Symptoms in Adolecents -Use of Self Rating Scale / Valsamma Eapen and Tawfik Daradkeh · Gilles De La Tourette Syndrome in Malta - Psychopathology in a Multiply Affected Pedigree / Valsamma Eapen and Mary M. Robertson
q SUMMARY / RESUMES / ملخصات
q Editorial § The Future of the Arab Journal of Psychiatry / Tewfik K. Daradkeh, Mohammad T. Abou-Saleh q Review § Tired and Depressed or just Tired. A Review of Psychiatric Morbidity Associated with Chronic Fatigue Syndrome / Janis Hillier & Anne Farmer ABSTRACT : Severe disabling fatigue with no obvious physical cause has been a subject of much debate within the medical profession and media over the last decade. Despite much effort to clarify the aetiology of chronic fatigue syndrome the aetiology and pathophysiology remain elusive. However, there is much evidence to suggest that whatever the cause depressive anxiety and somatoform syndromes occur more frequently than in healthy controls. We will compare some of the findings of a survey of psychiatric morbidity associated with operationally defined chronic fatigue syndrome (CFS) undertaken in Cardiff UK, with other studies undertaken in North America and Europe. There is a need for research in CFS to be carried out internationally and for more systematic investigations into all aspects of this chronic disabling disorder. Return in high q Views § Cultural Aspects of Illness Behaviour / M.Fakhr El-Islam q News § The Arabic Composite International Diagnostic Interview (CIDI) / Karam EG,Yabroudi P.Nasser Karam A.Mansour C.Sabah S&AI Atrash R. q Original Articles § The Diagnostic Values of Cortisol Suppression Test and Dexamethasone Suppression test in Depression / M.T Abou-Saleh, J. Collins & A. George ABSTRACT : Studies using Dexamethasone Suppression Test (DST) in depression showed rapid elimination of dexamethasone in association with non-suppression. To circumvent this phenomenon, cortisol was used as the suppressing agent (CST). Cortisol and prolactin levels were estimated following both DST and CST done in series in a group of depressive patients and normal subjects. Results of DST were generally consistent with those obtained by other investigations showing greater non-suppression of cortisol in depressive patients than normal subjects. Cortisol responses, however, were not suppressed following CST and similar values were obtained in depressive patients and normal subjects. Prolactin response to CST was significantly greater in depressive patients than normal subjects. Return in high § Schneider's First-rank Symptoms of Schizophrenia in an Arab Patient Population : Their Prevalence and Diagnostic Validity / Tawfik K Daradkeh , Emad Hamdi , Yousreya Amin *ABSTRACT :* This study was designed to estimate the prevalence and diagnostic validity of Schneider’s first-rank symptoms of schizophrenia in a sample of Arab patients with a major mental illness. One hundred sixty-eight (n=168) patients were selected for the purpose of this study from a larger population of patients who were previously recruited in the clinical field trials of the ICD-10 and in studies related to the reliability of the Arabic-English version of the Schedules for Assessment in Neuropsychiatry (SCAN). Most of the patients were assessed by pairs of clinicians, and in over two thirds of the cases diagnostic structured interviews were applied. The OPCRIT system was applied to these patients to yield diagnostic categories along different operational diagnostic criteria of schizophrenia (DSM-111, DSM-111-R, ICD-10, RDC, Feighner’s, Schneider’s and French criteria). Frequencies of individual first rank symptoms were found to be low but discriminated significantly among psychotic patients with the exception of delusional perception. Their sensitivity and specificity ranged between 0,4 to 0,6 and 0,75 to 0,89 respectively, depending on the operational definition of schizophrenia. Sensitivity of Schneider’s symptoms was highest among patients with RDC and ICD-10 schizophrenia. Estimates of the diagnostic efficiency of Schneider ‘s symptoms suggest that they add significantly to the accuracey in the diagnostic classification of schizophrenia. The authors conclude that by deleting Schneider’s FRS from the diagnostic algorithm of schizophrenia, it is highly unkikely that improvement in the classification rate of the disorder will take place in the absence of pathognomonic symptoms that are yet to be ascertained. Return in high § The Positive - Negative Distinction In Schizophrenia : Is it Sufficient ? / Halim Z., MoussaS., Abd El Gawad T.,El Bakry A.,El Batrawi M.,Askar M. ABSTRACT : Research and treatment of schizophrenia have been impeded by its heterogeneity and the lack of comprehensive assessment of symptoms including the positive/negative dimension. To study symptom profiles in subjects with schizophrenia, there fore, a well operationalized 30-item scale (Positive & Negative Syndrome Scale) was administered to 150 subjects with schizophrenia. The thirty items were then subjected to principle component analysis. Results showed that the positive/negative distinction alone was insufficient to account for the heterogeneity of schizophrenia. Other dimensions such as depression and excitement may further account for multiplicity of symptoms in this disorder. Return in high § Gender Differences in Psychiatric Admissions : The Influence of Culture and Social Structure / Yousreya Amin & Emad Hamdi *ABSTRACT :* Retrospective analysis of all psychiatric admissions in Al Ain District over 5 years (n=2745) showed a consistent excess of male over female inpatients by a ratio of 1.49 :1. To explore this phenomenon all admissions during a period of three months were prospectively assessed using a modified form of the Bethlem Royal and Maudsley Hospital observation sheet. In addition to sociodemographic characteristics, personal history, medical and psychiatric history, symptom profile and investigations, the assessment also covered treatment outcome as assessed by the clinical Global Impression Scale. A number of gender differences emerged Past psychiatric history revealed that male patients had more often sought contact with psychiatric services and had more frequent previous admissions when compared to their female counterparts. Apart from birth order, no differences were found in the circumstances of upbringing, or that of development. Male patients with a psychotic disorder more often exhibited delusions of persecution and received a diagnosis of schizophrenia. Patients admitted for alcohol and drug related problems were exclusively males. On the other hand increasing number of female patients presented with affective and conversion symptoms and consequent to which received diagnoses of affective disorder and conversion disorder. Female patients were more often considered to be markedly improved on discharge than their male counterparts, perhaps due to the different diagnostic profile. One way of explaining these findings would be to regard this as resulting from the influence of gender characteristics in the manifestation of psychopathology but the authors feel that this could more readily be explained by the idiosyncratic social fabric of the UAE. Return in high · Referrals by General Practitioners to a Primary Health Care Psychiatric Clinic - diagnostic Status and Sociodemographic characteristics. / Omer E. F. El-Rufaie ABSTRACT : This is a prospective study of new patients referred by general practitioners to a psychiatry clinic conducted within primary health care setting. Ninety six new patients (41 males & 55 females) were studied. Among the identified cases females were slightly more than males. The maximum psychiatric morbidity occurred at the age group 15-44 years and dropped sharply after the age of 45. Neurotic depression, anxiety state and anxiety-depressive state were the commonest identified psychiatric disorders (69%). Neurotic depression occurred more among females, otherwise no notable diagnostic differences between the two sexes. The results were compared with those of relevant local and international studies. Return in high · WHO / DAS or APA / GAF . A Difficult Choice / Tawfik K. Daradkeh & A. Saad ABSTRACT : The purpose of this study is to investigate the differences in the measures of disabilities (WHO/DAS) , and measures of functioning (APA/GAF). Simultaneous and independent ratings of the disabilities and the functioning of 20 acutely ill patients by two raters using the aforementioned scales, revealed that the ratings were highly correlated. Although the two scales differ in format, the results of this study indicate that they measure the same things. Return in high · Depressive Symptoms in Adolecents -Use of Self Rating Scale / Valsamma Eapen and Tawfik Daradkeh *ABSTRACT :* The Birleson Depression Self Rating Scale (DSRS) for children was evaluated in a group of non-referred adolescents in a school setting. The 18 item self report inventory demonstrated good psychometric properties. Although originally designed for use in children, the instrument proved to be a useful tool for screening of depressive symptoms in adolescents in a non-clinical setting. Return in high · Gilles De La Tourette Syndrome in Malta - Psychopathology in a Multiply Affected Pedigree / Valsamma Eapen and Mary M. Robertson ABSTRACT : A Maltese pedigree spanning four generations and multiply affected with the Gilles de la Tourette Syndrome is presented. The familial pattern of inheritance and phenomenological similarity across cultures point to biological factors in the aetiology of the syndrome. Return in high
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