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The Egyptian Journal of Psychiatry Vol. 22, N° 2, July (1999) www.imhotep.net\EPA.htm |
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CONTENTS / SOMMAIRE |
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§
Drug Abuse (Part II) / by Mahmoud S. AbdelGawad §
Scientific Methodology and Clinical Practice in Developing
Countries / by Y.T. Rakhawy §
Quality of Life in Handicapped Children
/ by Khadiga Dandansh, M.El Kalioby and M.H. El Defrawi §
Comparative Study of the
Reliability of an Egyptian Computerized Version of Beck / by M.A. Owida q
Journal
Abstract |
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q SUMMARY / RESUMES |
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§
Drug Abuse (Part II) / by Mahmoud S. AbdelGawad
§
Scientific Methodology and Clinical Practice in Developing
Countries / by Y.T. Rakhawy
§
Disciplinary Practices and Child Maltreatment
among Egyptian Families in an Urban Area Ismailia City / by Fatma Hassan,
Amany Refaat, H.F. El-Sayed and M.H. El-Defrawi ABSTRACT.
A household survey was conducted in El-Sheikh Zayed
district in Ismailia city to find out how parents treat their children under
18 years of age, and to determine the prevalence of abusive behaviors among
parents and its correlates with child and family characteristics. Three areas
were selected randomly from the 18 geographically defined areas of El-Sheikh
Zayed district. Census was done for the three areas using a specific form.
The eligible household was the household having a woman aged 15-49 years who
was a caretaker for at least a child less than 18 years. From a list of
eligible households 675 women were randomly selected.
The Arabic version of World Survey of Abuse Within Family Environment
(WorIdSAFE) was used. It included items about child and family
characteristics, the child's health status, the behaviors used by parents to
teach and discipline their children and how often they used these behaviors.
The questionnaire was pilot tested. The trained interviewers interviewed the
women in their households and privacy was ensured.
The participants
were 632 in number, but data of 602 children were eligible for analysis, as
infants less than one year were excluded from the study. Out of the 602
children 53% were males, and the child child's mean age was 9.67 +
4.95 years. Of the studied children, About half of the mothers (51.7%)
reported their child's health as excellent; while 14.6% suffered from chronic
health problems. Of their families 74.1 % were from middle class. Fifty three
percent of the parents included in the study used positive corrective
treatment, as verbal reasoning, with their children. While 45.7% of them used
psychological/emotional maltreatment with verbal aggression, and 42.5% used
mild/moderate physical maltreatment. Severe physical punishment (physical
abuse) was practiced regularly with 13% of the children and it was practiced
more frequently with children aged 9-12 years (OR=3.4,95% CI: 1.4-8). Factors
determined using psychological/emotional maltreatment and physical abuse
were: being a child difficult to take care of, being in good health, and the
previous history of the parents of being abused during their childhood by
their parents, and abused mothers by their husbands.
In this community severe physical
maltreatment was used much less than verbal reasoning by parents to
discipline their children. A program for parents to learn how to deal with
their children and how to establish an effective parent- child interaction
will help in encouraging using the positive behavioral correction. §
Quality of Life in Handicapped Children / by Khadiga Dandansh,
M.El Kalioby and M.H. El Defrawi
ABSTRACT:
Background. The need for
assessing the state of living or quality of life has increased in the last
few decades. The quality of living rather than longevity is the significant
consideration. Handicap in children represents a serious problem because it
will affect their school performance and later on their productivity in the
community . Assessment of health related quality of life in handicapped
children allows the description from a new point of view, giving valuable
information for improving their health care and for resource allocation. A
case control study aims to describe the quality of life in 82 handicapped
children was carried out. Cases were 57 child with hearing impairment from
the school of deaf and speech difficulties and 25 child with impairment in
motor function representing all cases attended the outpatient clinics of the
Suez Canal University Hospital during 3 months period; from May 1 to July 31.
They were compared with similar number of healthy controls from a regular
public primary school. The measure used was an Arabic version of culturally
modified Quality of life Questionnaire for children used in previous studies.
The questionnaire items was completed during a structured interview. A
qualified teacher in the school of deaf explained questions and received
children responses with sign language and with the help of associated
illustrated pictures. The results of this study point to the social and
psychological problems faced by the handicapped children, whatever the nature
of the impairment. However, children with impairment in motor function showed
significant lower quality of life than those with hearing impairment which
appears more in their reduced enjoying with hobbies and increased
psychological problems which reflects the great impact of the child's view of
his image on his quality of life in this age group. In contrast children with
hearing impairment reported greater impact of their state on cognitive
function reflecting their problem of communication. Conclusions: handicapped
children were lesser satisfied with their quality of life than normal
children, they reported social and psychological problems . This vulnerable
group needs more assessment for their real problems and more attention for
their need for care to help making them live with maximum capacity of
function.
RESUME. La
capacité de vivre chez les enfants handicapes
Dans les quelques dernières années, le
besoin d'évaluer l’état et al capacité de vivre a augmenté. Ainsi que le
genre de vie a un sens efficace plus que la longévité. Dalleurs, l'handicap
des enfants représente un problème dangereux, puisque il influence leur
performance scolaire et de plus leur productivité dans la société. On
l'évaluation de la capacité de vivre chez les enfants handicapés permet de
les décrite et cela a travers différents points de vue et qui nous donne des
informations volables pour développer les soins sanitaires et spécifier les
ressources. Donc, cette étude vise a décrire la capacité de vie chez 81 enfants
handicapés et cela en étudiant des cas comparables. Dans l'école des
sourds-muets, il y a un nombre de 57 enfants atteints d'un mal auditif, 25
autres atteints d'un affection musculaire: ils n'arrivent pas a me voir. Tous
ces cas représentent ceux qui sont venus a la clinique externe de l'hôpital
de l'université durant 3 mois. En outre, On les a compares avec d'autres cas
primaire ordinaire, On, la manière d'évaluation employée était à travers d'un
fiche de questionnaires se rapportant a la capacité de vivre des enfants et
qui était-elle utilisée dans des études précédentes. Par suites de cette
étudie, on a pu dégager les problèmes sociaux et psychologiques qu'affrontant
les enfants handicapes. Quelque soit la nature du mal. Maigre cela, les enfants empêchés de mouvements
représentante capacité de vivre moins que les autres dont l'audition est
affectée. Cette capacité se montre dans le fait de fournir de leurs loisirs
et dans leurs problèmes psychologiques qui reflètent l'influence de la vision
de l'enfant sur sa capacité de vie a cet âge. Par contre, les enfants
atteints d'un mal auditif sentent l’influence dé leur problèmes sur le
pouvoir de comprendre et qui surtout reflex le problème de communication chez
eux. Bref, les enfants handicapés acceptent leur vie par opposition aux
enfants naturels aussi sentent-ils leurs problèmes sociaux et psychologiques.
Ce groupe sensible a en plus, besoin qu'on évalue leur problème véritables et
voulait qu'on s'intéresse a leurs soins qui leur sont présentés et qui les
poussent à vivre avec la plus grande capacité. §
Domestic Violence and Female Genital Mutilation / by Amany Refaat,
Khadiga Dandash and M. Hassib El –Defrawi
ABSTRACT. Introduction : Wife heating by
their husbands was reported by 35% of women responding of EDHS-95
(Egyptian
Demographie Health Survey) results,
while female circumcision was universal among them (97%).
Objective: To determine the association between female circumcision
and attitude of Egyptian women towards wife beating by husbands.
Methodology: Secondary analyses of
women status questionnaire of EDHS 95 was conducted. The characteristics of
wife beaten including their circumcision status were investigated using tests
of significance. Acceptance that husbands are justified to heat wife was
examined against different women characteristics. Multivariate analyses was
conducted to determine if the practice of female circumcision leads to women
acceptance of heating per se or education, work, economic levels and
residence influence that acceptance.
Results: Showed that ever beaten women were
universally circumcised (99%), mostly from rural areas, living in lower
economic levels, not educated or had primary education, married to uneducated
husband or who bad primary education, and not working in their majority.
Acceptance of husbands are justified to heat wife was more likely to be 7.5
times among circumcised women than not circumcised ones. Results of
multivariate analyses showed that this influence is still the strongest
determinant even after introduction of education, working, economic level and
residence variables.
Conclusion: The study
concludes that female circumcision shapes the attitude of women to accept
abuse and beating. §
Memory and Social Behavior Changes Before and after Electroconvulsive
Therapy in Patients with Major Depression and Schizophrenia / by Seham
Rashed, Hoda Salama, M. El-Tayebani
ABSTRACT.
EIectroconvulsive therapy (ECT) was reported to have
faster and more sustained rate of improvement of major depression and
schizophrenia when compared to drug therapy. It may affect the cognitive
functions and / or behavior. This study was conducted to assess the memory
and social behavioral changes in patients with major depression and
schizophrenia receiving ECT. Twenty one patients with major depression and 23
with schizophrenia, were selected. Memory, tests and social behavioral
evaluation were done. The results showed no significant differences in memory
functions and social behavior after both unilateral and bilateral ECT in both
group of patients, except for significatif improvement of immediate memory
(digit span), visual motor performance (copy part of Bender Gestalt) and
psychomotor retardation in schizophrenic group. The trail making test became
worse after bilateral ECT than after unilateral ECT in schizophrenics but not
in major depressive patients with no significant difference. Also patients
who received more ECT courses during their life showed lower scores on digit
span
than those who did not. Duration of generalized
convulsions was positively correlated with improvement in patients'
activities.
RESUME.
Les troubles de la mémoire
et du comportement sociale avant et après les chocs électriques chez les malades
de la dépression majeure et du schizophrénie.
L'étude a porté sur 44
patients souffrant de la dépression majeure (21 patients) et du schizophrénie
(23 patients) qui ont prix des chocs électriques unilatérale ou bilatérale. Les
tests psychométriques ont été faits pour les deux groupes. Les données ont
été analysées et 005 était le niveau signifiante. Les résultats ont montré
que les deux méthodes de choc électrique améliorent les fonctions de la
mémoire et les fonctions du comportement social sans différence statistique
et nous avons trouvé une corrélation positive significative entre la durée du
choc général et l'amélioration d'activités des patients. Nous affirmons
l'importance de l'utilisation des chocs électriques soit unilatérales on bilatérale
dans les différentes maladies psychologiques en déterminant précisément les
raisons essentielles pour utiliser cette méthode efficace. §
Comparative Study of the Reliability of an Egyptian Computerized Version
of Beck / by M.A. Owida
ABSTRACT.
To
detect the reliability of an
Egyptian computerized version of Beek Depression lnventory (BDI) with its
well known traditional counterpart, the present study was designed. A sample
of 268 depressed patients were chosen along one year interval, half of them
were males and half were females. All fulfilled the diagnostic criteria for
depression according to the diagnostic criteria for research of ICD-10 and
had a Hamilton Depression rating score above 18 through a semi-structured
clinical interview. Half of the sample was tested by the traditional paper
and pencil version of BDI and the other half was tested with an Egyptian
computerized version of BDI developed by the author. Both groups were matched
as regards sex, age, education, marital status, occupation and degree of
severity of depression. Reliability was calculated through split-half
technique with person correlation coefficient between the two halves of each
group. The results indicated that the computerized version has a higher
reliability degree than its traditional counterpart. The reliability of the
computerized version was differentially affected by sex, age, education,
marital status and occupation, being higher among females, younger in age,
university graduated, unmarried and jobless. §
Weeks, Non-Comparative Study of the Safety, Efficacy and Toleration of
Sertraline in the Treatment of Obsessive Compulsive Disorder / by A. El-Dodd
ABSTRACT.
31
patients have been enrolled in this study. They were 27 females (87.1%) and 4
males (12.9%) and their ages ranged between 21 and 47 years. They all
suffered from obsessive compulsive disorder (OCD) according to the Yale-Brown
Obsessive Compulsive Scale (Y-BOCS), the obsessive compulsive rating
(NIMH-OC) and the clinical global impression illness severity score (CGI).
The admissible screening scores were 25 or greater for the Y-BOCS and 9 or
greater on the NIMH-C scale and 5 or greater on the CGI scale. All patients
were subjected to one week wash-out period before starting the active
medication. At patients were subjected to one week wash-out period before
starting the active medication. At baseline assessment, each patient must
have a total score of 20 or greater on the Y-DOCS and 7 or greater on the
NIMU-OC and 4 or greater on CGI to be randomised for active medication phase.
Sertraline was given as 50 mg/day then titrated to 100 mg/day and 150
mg/day al the end of week 4 and week 8 respectively if the response
was not satisfactory. Assessment was made by the Y-BOCS, NIMU-OC and CGI
scales, which were considered as the primary efficacy variables. The
Montgomery Asberg Depression Rating Scale (MADRS) and the Hamilton Anxiety
Scale (HAM-A) were used to measure secondary variables. The HAM-A Scale was
performed al screening, baseline and al the end of weeks 4,8 and 12. There
were a significant decline in the mean scores of Y-BOCS (p<0.01) starting
from the second week of treatment that re- corded 28.9, 11.2 and 5 white
their scores before treatment were 31.5, 10.6 and 6.0 respectively. The
scores continued to decline significantly (p<0.001) to reach 15.7,6.6 and
3.5 al the end of treatment. Sertraline was well tolerated by 20 patients
(64.5%) and 11 patients (35.5%) expressed mild adverse events. Sertraline was
proved to be effective and well tolerated in the treatment of OCD with or
without comorbid depression. §
Coping Strategies in a Group of Cancer Affected Egyptian Patients / by
Said Abdel Azim, Lamis El-Ray, Aza El-Bakry, Ola Shaheen & Ashraf Adel
ABSTRACT.
40
patients diagnosed to have leukemia or lymphoma were recruited from impatient
department of national cancer institutes and subjected to psychiatric
clinical assessment, SCL, POMS, NSSQ and dealing with illness coping
inventory. We aimed to study coping processes, amount and type of support and
psychiatric comorbidity. Results revealed a high level of social support,
especially emotional support, patients suffered from depression, fatigue and
anxiety the most and 42.5% had adjustment disorder with mixed anxiety and
depression. Active cognitive coping was the most coping strategy used
regardless of different variables studied. Passive resignation was the most
specific strategy used. Higher education level and urban culture use more
coping strategies. There is a significant relation between the amount of
psychological distress and the amount of coping. §
Descriptive Study of Some Egyptian Females Having Sexual Dysfunction
and Attending Al-Azhar University Hospitals, Results of a Clinical Study with
the Aid of Sexual Dysfunction Questionnaire / by M.A. Owida and A.E. Amin
ABSTRACT.
For the majority of people, the most
important relationship in their adult lives is sexual. Male sexual
dysfunction, in the literature, bad a greater interest than female sexual
dysfunction. Hence, in Egypt, little is known about female sexual dysfunction
either in the province of psychiatry or gynecology. Our study aimed at illustrating the socio-demographic and clinical profit of some Egyptian female patients having sexual dysfunction and attending AI- Hussein and Bab Alshareia Hospitals. Complete gynecological examination and semi-structured psychiatric interview with the aid of sexual Dysfunction Questionnaire were completed for every patient. The sample consisted of 163 patients who were selected randomly, above 18 years of age, married and diagnosed as having sexual dysfunction.
The majority of them lied in the
age group 20 and less than 30 years with a mean age of 27.5 years (+ 6.77).
Most of the sample were working and educated. 57.7% of the sample had a duration
of marriage of 7 years and more. 71.2% had children 59.5% of the sample
gathered their information about sex and marital relations from their
rnothers. The nilnority of the sample (5.5,7c) had + ve family history of
sexual dysfunction. Only 30.1% of the sample came complaining directly from
manifestations of sexual dysfunction. The majority of the rest of the sample
complained from pelvic heaviness (38.7%) and low back pain (28.8%). The most
frequently found diagnoses were. Nonorganic dyspareunia (15.3%), nonorganic
vaginismus (14.7%) and lack or loss of sexual desire (13.5%). The least
frequent were: marked feeling
of inadequacy of body and sex organs (1.8%), failure of
genital response (2.5%) and excessive masturbation (3.1 %). §
Clinical Assessment of Positive Negative Symptoms. Age of Onset and
Gender in a sample of Egyptian Patients Having Schizophrenia for More than
Two Years / by M.A. Owida, A.K. Wilson, Mona Tawfik, I. Abdel-Aal and I.M.
Yossef & M.A. Fatah Ahmed Mohamed
A. Fatah Ahmed Maher
ABSTRACT.
To assess the age of onset,
gender and positive/negative symptoms of schizophrenia, the current study was
carried out. The sample was comprised 45 outpatients diagnosed as having
schizophrenia according to ICD-10 diagnostic criteria for research for more
than two years and free of depression and of past or present history of
organic mental disorders, substance use disorders and major medical
illnesses. Patients were assessed through semstructured clinical psychiatric
interview, Hamilton Rating Scale for Depression, scale for the assessment of
positive symptoms and scale for the assessment of negative symptoms.
Our results showed that the mean
age of the sample was 32.96+11.84 years, two thirds were males and one
third were females. Age of onset of schizophrenia was at about 24.02±10.57
years. Males tended to have schizophrenia earlier than females in the early
onset subgroup. While, females tended to have schizophrenia earlier than
males in the late onset subgroup. Both positive and negative symptoms
occurred in noticeable percentages in the sample. Results based upon the
simple yes/ no occurrence of positive/negative symptoms revealed no relation
with either age of onset or gender while relying on the degree of severity of
symptoms, results denoted that early onset schizophrenic patients' had
severer degrees of bizarre behavior, allogia and evolution/apathy than the
late onset subgroup. Also results denoted that males tended to have severe
degrees of delusions, abolition/apathy and anbedonia/ asociality than
females. §
Effect of Chronic Rheumatic Heart Disease on Intellectual Function in
School Age Children / by Z.M. Mounir, H.F. Shafeye, H. Hassaballa, H.Ahmed,
H. Essawy
ABSTRACT.
A Case control design conducted
at the cardiology clinic of the new children hospital Cairo University a one
hundred children with chronic rheumatic heart lesion and another 50 normal
children divided into 2 groups as control (A) with the same socioeconomic
status while control (B) had higher social class. Their ages ranged from 6 to
12 years and both sexes were included in this study to evaluate the effect of
this disease to the psychosocial, intellectual and behavioral development of
the children. Both patients and controls were subjected to a designed
questionnaire sheet including the clinical data on anthropometric
measurements as well as the intellectual functions assessed by the
intelligence test. This study revealed that the patients height, weight, and
B.M.I. were significantly lowered with general delayed growth as regard the
other anthropometric measurements for this group of cases compared to normal
control. All patients showed significantly low intellectual function and
abnormal behavior compared to normal control (1) and more lower than control
(B). This current study concluded that children with chronic rheumatic heart
disease have growth retardation, intellectual decline and abnormal behavior,
so psychosocial supportive care is necessary to manage these patients. §
Knowledge and Attitude of Bedouins of Saint Catterine Towards Mental
Disorders / by M.H. El-Shatury, Ghada S. Eldin, A.H. Abdelimoneum, Maram M. Radwan,
M.A. Elabban, Monira T. Ismail, M.M. Ellabban, Nahla H. Kebeer, A.A. Abdalla
and M. Hassib El-Defrawi
ABSTRACT.
To assess knowledge and
attitude of Bedouins towards mental disorders., 81 subjects from Saint
Cathrine (South Sinai) were randomly and systematically recruited and
interviewed with a semistructured technique go obtain a profile of their
concepts and beliefs. Results showed that 89% of interviewee do not recognize
the term schizophrenia (Fusam) and 66.6% refused to work with a patient known
to have mental disorder. The implications of these finding suggest that
programs aiming at reduction of stigma of mental illness should target the
knowledge and attitudes of various community subgroups. q
Journal Abstract |
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| Document Code PJ.0107 |
ÊÑãíÒ ÇáãÓÊäÏ PJ.0107 |
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