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The Egyptian Journal of Psychiatry
Vol. 21, N° 1, January (1998) |
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CONTENTS / SOMMAIRE |
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§
Social
Psychiatry: (Part III) (Abstracts). / by Mahmoud S. AbdelGawad §
Depression,
Unhedonia and Psychic Pain The Need for Identification before Categorization / by Y.T.
Rakhawy §
Platelet Activity in Patients with
Myocardial Infarction and Concomitant Major Depression / by A.M. Kassem, Aly
A. El Sayeh, M. El-Kabsh and M.I. Ibraheem §
Incidence of Schizophrenia
at First Admission in Bahrain / by M. AbdulKarim and M.K. Al Haddadr §
Depression
in Parkinson’s Disease A Clinical Study / by Gamal Shama §
Psychiatric
Aspects of Burns / by M.R. Kandil, A.A. El-Sayeh and M.A. El-Otiefy §
Psychiatric
Morbidity in Rheumatological Disorder / by A.M. Al-Jadiry and S. Kamil Ali q
Journal Abstracts q
Thesis Review
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q SUMMARY / RESUMES |
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§
Social Psychiatry: (Part III)
(Abstracts). / by Mahmoud S. AbdelGawad
§
Depression, Unhedonia and Psychic Pain
The Need for Identification
before Categorization / by Y.T. Rakhawy
§
Neuro-Psychological
and Psychiatric Aspects of Subclinical Hepatic Encephalopathy / by R.
Al-Jamal and A. Abdallah
ABSTRACT:
The sample of this study
consisted of 24 patients with age range of 5-15 years suffering from non-active liver
cirrhosis and 20 normal control subjects matched for age, sex and education with the patient group. They
were subjected to medical, neuro-psychological and psychiatric assessment.
The neuro-psychological testing
involved testing of both the performance ability, which was impaired in
patients and the verbal ability, which was preserved. The different medical
parameters whether clinical signs and symptoms or laboratory investigations
were tested for correlation with
the neuro-psychological abnormalities and no correlations were found except
for prothrombin level. Psychiatric assessment included clinical mental status examination,
the use of brief psychiatric rating scale and personality assessment form. Individual psychiatric
symptoms detected by clinical mental state examination did not show
significant differences between the patients and the control subjects
although psychiatric symptoms - in general - were significantly more in the patients. However, the use of
the brief psychiatric rating
scale revealed the prevalence of some psychiatric symptoms more
significantly in the patients than the control subjects. Personality
assessment revealed that generally, patients were more emotional, anxious and
easily provoked. However, there is no evidence that these psychiatric symptom
and personality characteristics
could explain the existing neuro-psychological abnormalities.This
study concluded that cases of subclinical hepatic encephalopathy
significantly defected bv neuro-psychological testing might have particular
psychiatric and personality
profile, which is not manifest by clinical mental state examination, but
clinical psychiatric scales could reveal it. These personality and
psychiatric features - though not out-standing, might put a question mark on
the assumption of previous studies that these. patients have - on clinical
examination - normal
mental status,
RESUME. Aspects
neuro-psychologique de l'encéphalopathie hépatique sans signes cliniques.
L'étude
a porté sur 24 patients âgés de 5 à 15 ans, souffrant de cirrhose hépatique non-active et un
groupe témoin de 20 personnes pariés pour l'âge, le sexe et le niveau
scolaire. L'étude a montré que les patients souffrant d'encéphalopathie
hépatique sans signes cliniques
pourraient présenter un profile psychiatrique et un profile de
personnalité particuliers, que l'on peut détecter en utilisant des tests neuro-psychologiques. §
Behavioral
Habits and Cognitive Functions of Elderly People in Port-Fouad Area / by I.
Youssef, M El-Geneidy and S. Abo-Abdo
ABSTRACT:
A Cross sectional descriptive
study was done on 300 elderly (172 males and 128 females). They were interviewed using behavioral
habits questionnaire and
Minimental scale (MMS). The mean age was 67.3 years. It was found that
64.6% were independent as regards ADL (Activity of dally living). Praying was
the most important reason for
going out (39.3%), while shopping came next (29%), seeking medical
examination (20%). In addition, 28% of the sample bas a score less than 24 in
MMS. There was a statistically significant difference between male and female
as regards cognitive functions. There was au inverse relationship between
smoking and cognitive impairment, but the difference is not significant. The study revealed insignificant
relationship between behavioral habits and cognitive functions of the elderly
with the exception of practicing exercise.
RESUME.
Les habitudes de comportement et les fonctions cognitives des
personnes âgées à Port- Fouad
300 personnes âgées ont été
examinées pour valeur leurs fonctions cognitives et leurs habitudes de comportement. Leurs
âge moyen était 6.73 ans. On a
trouvé des différences significatives dans les fonctions cognitives entre les femmes et les
hommes. On a aussi trouvé des relations différentes entre les habitudes de
comportement et les fonctions cognitives. §
Platelet Activity in Patients with
Myocardial Infarction and Concomitant Major Depression / by A.M. Kassem, Aly
A. El Sayeh, M. El-Kabsh and M.I. Ibraheem
§
Assessment of the
Quality of Life of Patients on Chronic Hemodialysis / by I.M. Youssef and
M.S. E. Khedr
ABSTRACT:
The study was conducted on 76
patients (48 males and 28 females) on chronic regular hemodialysis for one
year or more to assess the quality of life. The patients were enrolled from
Ismailia dialysis units. Quality of life index was designed to include 8 items . work productivité, daily
living activities, sleeping pattern,
social and leisure activities, sexual activities, psychological status,
family functions and patient's outlook and patient's perception of health. The attitude of patient
towards dialysis and his religions orientation were obtained through a controlled interview. Zung self
rating scale for depression was applied. Presence of other medical problems
was obtained by reviewing patient's record. lt was found that 17 patients had
good quality of life (QOL), 30 had fair QOL and 29 Patients had poor QOL.
There was no difference in the results as regards sex and age groups. There
was a significant decrease of QOL in illiterate patients, patients with other
medical problems, patients with negative attitude towards therapy, patients
with weak religions orientation
and depressed patients.
RESUME. L'évaluation
de la qualité de vie des patients hémodialisés
L'étude a été
conduite sur 76 patients (48 hommes et 28 femmes) maintenus sur hémodialise régulière pour une période d'un
an ou plus. Le but était d'évaluer leur qualité de vie. Les indices de la
qualité de vie incluaient 8 items: les performances professionnelles, les
activités de tous les jours, la qualité du sommeil, les activités sociales et
de loisirs, la fonction sexuelle, l'état psychologique, le fonctionnement
familiale et le positionnement par rapport à la notion de santé. Nous avons
aussi explorer à
travers un entretien l'attitude des patients vis-à-vis de la dialise et l'orientation religieuse.
L’échelle de la dépression de Zung a aussi été utilisé. Il y avait une baisse
significative dans l'évaluation de la
qualité de vie chez les patients illettrés, les patients ayant
d'autres problèmes médicaux, les
patients ayant des attitudes négative vis-à-vis des soins, les patients ayant une faible orientation
religieuse et les patients déprimés. §
Neurobehavioural Effects
of Lead Exposure on School Children / by B.M. Abdel-Hady, M. Hassib
El-Defrawi and I. Youssef
ABSTRACT:
Objective - 1-To find out the
blood lead level in children aged 9 - 11 years in urban and rural Ismailia,
Egypt. 2 - To find out the effect of high blood lead level on
neurobehavioural test scores Design : A cross - sectional study . Setting -
Urban and rural primary schools in lsmailia, Egypt. Participants- 250
children (125 from urban and 125 from rural areas ). Main outcome measure :
Scores in The Wechsler intelligence test, and the Matching Figures test.
Results : The mean blond lead lever in urban and rural areas 18+5.31ug/dl, and
17.8 + 8ug /dl respectively . Overall, 62% of the children had lead
level < 15 ug/ dl, . This effect was still present after controlling for
the confounders . Conclusion : lead pollution is an important problem in
Egypt. It is associated with lowered performance in neuro-behavioral tests a
community wide intervention program is strongly recommended to combat this
problem .
RESUME. Les
effets neuro-comportementaux de l'exposition au plomb chez des enfants d'âge scolaire
Les
objectifs de cette étude est d'evaluer le niveau sanguin de plomb chez des enfants de 9 à 11 ans
habitant des régions urbaines et
rurales à Ismailia en Egypte et de voir les effets
neurocomportementaux, d'un taux sanguin de plomb elevé.
Nos
résultats soulignent que la pollution au plomb est un important problème en Egypte, cette
pollution est associée avec de
moindre performances dans les tests neuro-comportementaux. Nous
proposons un programme d'intervention communautaire afin de combattre ce
problème. §
Study on
Benzodiazepines Users among Adult Sudanese Rate of Prescription and
Dependence / by D.El Gaili and O. Abdu
ABSTRACT: Adult patients attending Omdurman Medical and
Psychiatrie Out-patient Clinics
during a nine month period were studied in relation to aspects of
Benzodiazepines (BZD) use. The BZD prescription rate was estimated as 4.64% This was found to approximate estimates in
industrially developed countries. Higher prescription rate was found in the
Medical as compared to the Psychiatric clinic. The rate of BZD dependency was
estimated as 45%. The duration of use was the most important factor. Long duration of BZD use was associated
with more cases of BZD dependence It is concluded that there are evidences
for invalid prescription for BZD by doctors working in general practice. BZD
were used unjustifiably for long duration.
RESUME. L'usage
de Benzodiazepines parmi les adultes Sudaneses.
Ou a
étudié la relation entre l’usage de bengzodiazepines et les malades Sudanses fréquentés les cliniques
psychiatriques et les autres
cliniques dans un période de 9 mois à l’hôpital d'Omdourmane. On a
trouvé que le taux de la prescription de BZD est 4.64%, le taux de dépendance
de BZD est 45%, le taux deprecription de BZD chez les autres cliniques médicaux sont plus
élèves que celui de clinique
psychiatrique l'emploie de BZD pour longtemps est associé avec la
dépendance de BZD chez des plusieurs cas.
Les résultats
de cette étude a comme conclusion de l'importance de l'invalidité de prescription
de BZD chez les docteurs non-spécialisé. §
Adolescent Attitudes Towards their Family, Peers School and the
Community / by Amira Seif El-Din and Yousre AbdelSalam
ABSTRACT:
Adolescent is a development
period of rapid physical , psychological, sociocultural and cognitive changes
characterized by effort to confront and establish a sense of identity and autonomy The present study aims to
assess present adolescent's attitudes their family , peers , school and
community , and the desired
attitudes that they are missing in these areas. The sample constituted
of 160 High - School students ,
tool was a self rating questionnaire, data were analyzed and 0.05 was the
level of significance. The result showed that the most problems faced by an adolescent are the family
problems and the desired and missing of love, cooperation and communication
within the family, pears, school and community . There was a significant relation
between adolescent's towards what
they expect to be in his family , peer, school and community , with
their type of educational system , sex scholastic and father's education Our
findings suggest the importance
of the family, school and mass media roles in developing adolescent's self
esteem and subsequently their mental health competency
RESUME.
L'attitude des
adolescents chez leur famille , écoles, camarades et aussi leur communautés.
Cette étude a comme bute
d'évaluer le présent attitudes des
adolescents chez leur famille, écoles, camarades et aussi leur
communautés.
Un échantillon de 160
étudiants au niveau secondaire ont été choisis et le questionnaire (self rating questionnaire) a été appliqué.
Les données ont été
analysé et 0.05 était le niveau signifiante les résultats ont montré que les
majeures des problèmes faces l’adolescent sont les problèmes de la leur
famille, la relation entre les membres de la famille, école et la communié
aussi qu'il y a une relation signifiante entre l’attitude excepté des jeunes et le niveau éducatifs., et
culturelle des parents.
Les résultats trouvées
proposent ou montrent l'importance du rôle de la famille, école et masse
media sur la développement des jeunes eux -mêmes et en conséquence et leur
santé mental. §
Clinical
Comorbidity of Depression and Personality Disorders among Women Attending
Al-Hussein Hospital / by M.H. Kamal Bahri
ABSTRACT:
The study was implemented on
100 individuals attending AI-Hussein Hospital, from November 96 to April 97.
They were divided into Croup 1 including 50 depressed married female
patients, their age ranged from 20 to 30 years with a mean age of 25, and Group Il with 50
normal married females, their age ranged from 20 to 32 with a mean age of 26. Both Croups
were subjected to Comprehensive medical and psychiatric examination and
Personality Assessment inventory
and Beck lnventory scale for Croup 1. The distribution of the
different types of depression
among Group 1 showed that Dysthymia and Major Depression constituted the
highest percentages reaching 52% and 22% respectively. Cyclothymia patients accounted for 18% of
the depressed patients with the bipolar 1 and bipolar Il disorders each
constituting 4% of the depressed Croup. The study revealed that 31 out of 50 depressed
patients (62%) had personalitv disorders. In comparison, only 6 individuals
(12%) of the control Croup had personality disorder with a significant difference
(p<0.0005). This suggests a positive correlation between depressive and personality
disorder. Since major depressive disorder and Dysthymia constitute the
highest percentage among Group 1 patients, it is important to analyze their relationship
with the various types of personality disorders. The statistics show that 5 individuals
out of 12 major depressed patients had borderline personality disorder
(41.6%). Major depression is also associated with other types of personality disorders,
including schizotypal (17%), histerionic (17%), avoidant,(8%),dependent(8%)and depressive(8%)
personality disorders. Another type of depression that correlates highly with
personality disorder is Dysthymia (p<0.0005). The highest occurrence of
personailty disorder types for dysthymic patients were histerionic (30.8%).
dependent (15.4%) and borderline
(15.4 %) personality disorders. Although the comorbidity between
personality disorder and other types of depression other than the major
depressive and dysthymic disorders is not statisticallv significant, the
percentage of patients suffering from depression other than Dysthymia and
major depression who also suffer
from personality disorder reaches 19.2 %, which is a percentage not to
be neglected. To conclude, the diagnosis of depression and axis II
personality disorders have been
found to co-occur in female patients. In specific, there is a strong
link between major depression
disorders, Dysthymia and personality disorders. This link will bave an implication on the
method of treatment suggesting that drug treatment in addition to psychotherapy should be combined
in handling this problem.
RESUME.
Comorbidité entre
dépression et trouble de la personnalité parmi une population de femmes consultantes à
l'hôpital AI-Hussein.
Nous avons effectué une
étude sur 100 femmes consultantes à
l'hôpital AI-Htmein, 50
présentaient un trouble dépressif
principalement dépression majeur et dysthymie, les 50 autres femmes ne
présentaient pas de troubles psychiatriques et formaient un groupe témoin. Le but de l’étude était
d'évaluer la comorbidité entre
trouble dépressif et
trouble de la personnalité.
Nous avons trouvé une corrélation
positive entre le trouble dépressif et le trouble de la personnalité, une
corrélation significative a été trouvé entre la dépression majeur et le trouble de la
personnalité de type borderline
ainsi qu'une corrélation significative entre la dysthymie et le trouble de la personnalité de type
histrionique.
Nos conclusions confirment l'existence d'une comorbidité entre le diagnostique de trouble dépressif, principalement la dépression majeur et la dysthymie, avec celui de trouble de la personnalité chez les patients de sexe féminin de notre étude. Cette association devrait peser sur les méthodes thérapeutiques en associant pharmacothérapie et psychothérapie dans ce type de pathologie. §
Infantile Autism in
Egyptian Children Assessment and Clinical Correlates / by M.H. El-Defrawi, A.
Atef and M. Arafa
ABSTRACT:
Infantile autism is a serious
developmental disorder of childhood characterized by an early onset of severe
delays in social, communicative and cognitive development with generally poor
prognosis, the present study reports on reliability and validity of ratings of 37 Egyptian autistic children
and adolescents surveyed from 9
centers serving the mentally handicapped (n = 449). The Arabic version of childhood Autism Rating Scale (CARS)
was used in inter-rater and test- retest studies by multiple raters. Agreements and disagreements
in relation to different areas
of dysfunction were satisfactory and showed an overall utility and
practicality.
The second part of this study
describes the perinatal, developmental and behavioral correlates of those
children. Autistic children and adolescents have significantly higher adverse
perinatal events than their controls (P<0.001). our results suggest that
using a reliable scale to assess autistic children was useful, and that their may be a subgroup of
autistic children with etiological factors related to perinatal adverse events.
RESUME.
L'autisme Infantile Chez Les
Enfant Egyptiens évaluation et
Manifestations Cliniques.
L'autisme
infantile est un trouble grave du développement caractérisé par le début
précoce d'un retard important du développement sociale, communicatif et cognitif avec généralement un
pronostique défavorable, cette étude porte sur la fiabilité la validité de la
méthode d'évaluation ayant permis de centres pour arriérés mentaux
(n=449).
La deuxième partie de cette étude
décrit les facteurs périnatals, de développement et comportementaux associés
chez ces enfants. Les enfants et adolescents autiste ont été exposé à des traumatisme périnatals d'une
façon significativement plus élevé que le groupe témoin (P=0.001). Nous
pensons que l'utilisation d'une
échelle d'évaluation afin de tester les enfants autistes était utile, et que
il pourrait y avoir un sous groupe d'enfants autistes avec une étiologie liée
à des traumatisme périnatals. §
Incidence of Schizophrenia
at First Admission in Bahrain / by M. AbdulKarim and M.K. Al Haddadr
ABSTRACT:
This is a study of hospital
incidence rates of schizophrenia at first admission in Bahrain. During the
period 1988-1996, 325 Bahraini Schizophrenic patients were admitted; 200
males and 125 females. The mean
age was 28.4 + 7.6 years. The average annual incidence rate was
1.29 per 10,000 population for all ages and 2.13 for ages 15-54 years. There
was gradual and steady decline
in the incidence rates for males, females and both sexes combined for all ages and ages 15-54 years.
Various reasons for the
decline in incidence are discussed.
RESUME.
L’incidence
de schizophrénie pour la première fois à l’hôpital du Bahrain. Une étude a été faite pour évaluer le taux d’incidence de schizophrénie dans une période 1988-1996 à l’hôpital du Bahrain les résultats ont démontré que 325 schizophrénies ont été admise à l’hôpital (200 hommes, 125 femmes) avec moyen âge de 28,4 années. Le taux d’incidence annuaire est 129/10.000 populations, il y a une d’échine graduel au taux d’incidence et aussi les raisons de se décadence seront discutés. §
Attention Impairment
in First-Degree Relatives of Schizophrenic Patients : Neuropsychological
and Neurophysiological Evidence / by O. Madkour, S.A. Kamal, A. Hashem and
M.R. Raslan
ABSTRACT:
Fifty-five first-degree
relatives of schizophrenic patients were compared to an age and sex-matched control group of
thirty normal subjects. The main aim was to look for evidence of impaired attention in the study
group. Neuropsychological
assessment used Cancellation Tests and Reaction Time.
Neurophysiological investigation was performed using P300 component of
auditory evoked cortical potential. Obtained findings showed impairment of
attention in the study group. These results were a proof of the
hereditability of impairment of attention in families of schizophrénies.
Studying attention in high risk groups for schizophrenia may prove useful in
detecting vulnerable individuals. This may be a step foreword in organizing a program for primary
prevention of schizophrenia.
RESUME.
Trouble de l'attention chez les
parents de premier degré de patients schizophrènes :Indices
neuro-psychologiques et neuro-physiologiques.
Nous avons conduit une étude
comparative pour évaluer le trouble de l'attention chez 55 parents du premier
degré de patients schizophrènes contre un groupe témoin de 30 personnes pariés pour l'âge et le sexe.
L'évaluation
neuro-psychologique et neuro-physiologique a mis en évidence un
trouble de l'attention chez le
groupe des parents de premier degré des
patients schizophrènes. Ces résultats soutiennent l'hypothèse de
l'hérédité du trouble de l'attention dans les familles de patients schizophrènes. L'étude de l'attention
dans les groupes à haut risque pour la schizophrénie pourrait être utile afin de dépister
les individus vulnérables, cela
pourrait servir aussi afin d'organiser un programme de prévention
primaire pour la schizophrénie. §
Depression in
Parkinson’s Disease A Clinical Study / by Gamal Shama
ABSTRACT:
This study was done on thirty patients with
Parkinson's Disease (PD) and ten
normal persons as a control in Neuropsychiatry department in Tanta
University Hospital.
Neuropsychiatric examination and application of DSM III were done for all of
them. Certain scales as Hamilton rating scale of depression (URSD), Hoehn and
Yahr stages of PD (H and Y) and Modified Cornel UCLS Parkinson Dlsease Rating
scale were done. The study showed that depression occurs in 56.67% of patients with PD, 64.71% meet
criteria for major depressive episodes, 35.29% have dysthymia. Depression in PD is distinguished from
other depressive disorders by a lower rate of depressed mood, anxiety
symptoms, guilt and suicide. There was significant association between the
patients age at the onset of PD and depression. However, there was no
significant association between sex of patients and depression. No
significant correlation between depression and motor manifestations of PD
(tremar, rigidity, bradykinesia and postural instability) and between either motor disability or duration
of PD and depression. So, we. can conclude that, depression in PD is a biological one. It is hoped
that future studies may illuminate the neuropathological and neurochemleal
changes underlying the association of depression and PD.
RESUME. La
dépression dans la maladie de Parkinson. Une étude clinique .
Cette étude a porté sur 30 patients
atteints de la maladie de Parkinson et 10 autres personnes, non atteintes,
comme groupe témoin. L'étude a montré que la dépression avait une prévalante
de 56.67% des patients atteints de la maladie de Parkinson, 64.71 % d'entre
eux répondaient aux critères de l'épisode dépressif majeur et 35.29% à celui
de la dysthymie. La dépression associée à la maladie de Parkinson se
distingue des autres troubles dépressifs par une moindre incidence de
l'humeur dépressive, de l'anxiété, de la culpabilité et du suicide. Il n'y
avait pas de corrélation significative entre les troubles moteurs ou la durée
de la maladie de Parkinson et la dépression. §
Psychiatric Aspects of Burns
/ by M.R. Kandil, A.A. El-Sayeh and M.A. El-Otiefy
ABSTRACT:
This study was carried out in Assiut
University Hospital, on 50 burned patients and 30 control cases. The study
showed that burns occur more frequently below age of 40 years (86%) flame was
the commonest cause of burn and house- wives were the most common victims.
(42% of burned patients). 18% of the total burned cases had preburn
psychiatric disorders, while 64'% of the total burned cases had post -
burn psychiatric disorders. Clinical intrview and application of psychiatric
scales showed that burn cases were more affected than control cases.
RESUME. Etude
Psychiatriques des Brûlés.
Cette étude a été
conduite à l'hôpital universitaire de l'université d'Assiout sur 50 patients
brûlés et 30 autres patients comme groupe témoin.
Nous avons trouvé que 18% des patients
brûlés présentaient des troubles psychiatriques avant leur brûlures, tandis
que 64% des patients brûles présentaient des troubles psychiatriques après
leurs brûlures. §
Psychiatric Morbidity in Rheumatological Disorder / by A.M. Al-Jadiry and S. Kamil Ali
ABSTRACT:
The psychiatric morbidity in 100
patients with rheumatological disorders and 100 apparently healthy
individuals was compared, The General Health Questionnaire - 30 (GHQ-30) and
(DSM -III-R) based Semi - Structured interview (SSI) as a psychiatric means
for evaluation were employed.
The results revealed that the patients had, statistically,
insignificantly higher psychiatry abnormalities than the control, and that
affective disturbances were the predominant ones.
The relationship of these abnormalities to
several socio-demographic variables, and type of rheumatological diagnosis
was discussed.
RESUME.
Morbidité Psychiatrique Dans Les
Troubles Rhumatologiques.
Nous avons comparé le taux de morbidité
psychiatrique chez 100 patients souffrant de troubles rhumatologiques et 100
individus apparemment en bonne santé.
Les résultats ont montré que les
patients présentaient un taux, statistiquement insignifiant, plus élevé de
troubles psychiatriques que les individus en bonne santé, les troubles de
l'humeur étaient prédominants.
Nous
avons examiné le rapport entre ces troubles et plusieurs variables
socio-démographiques ainsi que le
diagnost
rhumatologique. q
Journal Abstracts
q
Thesis Review
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ÊÑãíÒ ÇáãÓÊäÏ PJ.0106 |
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