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THE ARAB JOURNAL OF PSYCHIATRY

Vol. 10, No. 2, November (1999)

E.mail: takriti@nol.com.jo

 

q        CONTENTS / SOMMAIRE /  

q       Leading Article        

          Psychopathology and Physical Illness in Disasters and within the Inner City / Haroutune K. Armenian

 

q       Review Articles    

          Psychological Treatment of Substance Misuse: A Review / C. Kouimtsidis, M. T. Abou-Saleh

          The Role of Day Hospitals in Modern Psychiatry / Mariwan Husni, Jawad Sheikh, Narmen Koye, John Naggerty

 

q       Papers     

          Stages of Change and Self-Esteem among Opiate Users / Abdullah. M. AI-Otaibi

          Deliberate Self-Harm in the Elderly. A Comparison with Younger  Adults / Walid Abdul-Hamid, Martin Smith, K. Sivakumar

          The Sociodemographic and Clinical Pattern of Hysteria in Saudi  Arabia  / Tariq A. AI-Habeeb, Yousef 1. Abdulgani, Mohammed S. AI-Ghamdi, Mohammed T. AI-Jundi, Naseem A. Qureshi

          Nicotine Dependence and Its Relationship to Depressive Anxiety  Symptoms Among Saudi University Students / Abdullah Sultan Ai-Subaie .

          Religions Identity in Egyptian Muslim and Christian Children  Aged 6- 13 Years / Rachel Allison Royle, Martyn Barrett, Yahya Takriti

          Factitious Disorders:. Sociocultural and Clinical Factors Among Saudi  Patients  /  Naseern Qureshi, Tariq AI-Habeeb, Muzamil Abdelgadir, Yasser AI-Ghamdy

          Self Mutilation / Hussein S. Hassan

 

q       SUMMARY / RESUMES /  

q       Leading Article        

         Psychopathology and Physical Illness in Disasters and within the Inner City / Haroutune K. Armenian

 

q       Review Articles    

         Psychological Treatment of Substance Misuse: A Review / C. Kouimtsidis, M. T. Abou-Saleh

ABSTRACT :  Substance Misuse is a universal major problem with medical, psychological and forensic dimensions and consequences. Treatment approaches to substance misuse should address its complexity, with pharmacological, psychological and social interventions having an important role to play, either separately or in combination. This article will focus on the psychological approaches. There will be brief presentation of the models and the theory behind them as well as reference to research evidence supporting their efficacy. At the end there will be more detailed presentation of the theory and practice of cognitive behavior therapy in substance misuse.

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         The Role of Day Hospitals in Modern Psychiatry / Mariwan Husni, Jawad Sheikh, Narmen Koye, John Naggerty

ABSTRACT : Day hospitals for mentally ill patients provide a setting where patients can be actively treated and assisted to develop proper skills for better coping with their illness and stress in general. They provide a unique setting in which diversified skills in the management of the mentally ill patients are used effectively. Day hospitals are cost effective in the spectrum of care for psychiatric patients. This paper discusses the role of day hospitals in the current practice of psychiatry. The discussion is based on review of the recent    literature, visits to a number of day hospitals in Solihull and Birmingham in west midlands, U.K. as well as interviews with the consultant psychiatrists in charge of them.

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q       Papers     

         Stages of Change and Self-Esteem among Opiate Users / Abdullah. M. AI-Otaibi

ABSTRACT : The aim of this study was to investigate the relationship between self-esteem and stages of change among heroin users on methadone maintenance at the Maudsley Hospital. The sample was 31 male and female subjects. Subjects were given a self-esteem questionnaire and stages of change questionnaire. They have been classified to five stages, Precontemplation, Contemplation, Preparation, Action, Maintenance. Data was analyzed by using Spearman correlation coefficient. Results showed that there was a correlation between self-esteem and stages of change (N=32, r=4723, p= < 007). This study suggested that this result would help us to assess heroin users at treatment.

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         Deliberate Self-Harm in the Elderly. A Comparison with Younger  Adults / Walid Abdul-Hamid, Martin Smith, K. Sivakumar

ABSTRACT :  OBJECTIVES : This study aimed to describe the elderly deliberate self-harm (DSH) cases in Maidstone and compare them with younger adult DSH cases.

      Design and Setting : Structured information on all DSH cases admitted to Maidstone Hospital has been dept by the DSH team for 4 years. We analyzed the records of all DSH cases who were over 65 years and compared them with a random sample of the younger adults DSH cases presented to the services during the same period.

      RESULTS : The number of the elderly DHS cases in Maidstone was in the lower levels of the prevalence suggested in previous studies. These elderly exhibited higher suicidal risks and has more serious suicidal attempts.

      CONCLUSION : The association of the elderly DSH with physical health problems and the possible low referral rate of elderly DSH to A&E department suggest the need to move the DSH team work to primary care.

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         The Sociodemographic and Clinical Pattern of Hysteria in Saudi  Arabia  / Tariq A. AI-Habeeb, Yousef 1. Abdulgani, Mohammed S. AI-Ghamdi, Mohammed T. AI-Jundi, Naseem A. Qureshi

ABSTRACT : The objective of this study is to describe prospectively the sociodemographic and clinical parameters of patients with hysteria presenting

 to Psychiatric Emergency Services of five regional hospitals in Saudi Arabia.

      METHOD :  This multicenter study recruited 132 patients with hysteria, diagnosed in accordance with the Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorder criteria (DSM IV).

      RESULTS : The majority of patients were females (70%), young (< 30 years, 87%) and single (63%). Most of them presented with conversion disorder (98%) and were chiefly characterized by a single symptom. The most frequent symptoms whether single or in combination with other symptoms were aphonic (31,2%), fitlike movements (29,6%) and loss of consciousness (25,6%). A proportion of patients (23,5%) was clinically depressed.

      CONCLUSION : The socioclinical pattern of hysteria in Saudi Arabia appears to be changing. It is mostly consistent with international data but the explanations are different. In light of this study and other reviewed researches, it is suggested that a long-term study should be pursued in order to identify the final course and outcome of such clients.

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         Nicotine Dependence and Its Relationship to Depressive Anxiety  Symptoms Among Saudi University Students / Abdullah Sultan Ai-Subaie .

ABSTRACT : OBJECTIVES : This study aims at examining the prevalence of nicotine dependence and its relationship to depression and anxiety among Saudi University students.

      Design, Setting and Participants : A sample of University students were selected including equal number of males and females.

      Main Outcome Measures : Students were asked to fill out the World Health Organization questionnaire on smoking and the Hospital Anxiety Depression Scale (HADS). A semi-structured interview was used on a pilot sample of students to ensure the validity of the HADS in the non-clinical population. The Fagerstrom Tolerance Questionnaire (FTQ) was used to identify nicotine dependents.

      RESULT : The prevalence of nicotine dependence was 3,3% of the total sample and 20,7% of the smokers. Nicotine dependents were not different from non-dependent in demographic data but they smoked more cigarettes for a longer duration, had difficulty in refraining from smoking in prohibited places, smoked even when very ill and inhaled smoke into their lungs. Also, they had significantly more cases of depression and anxiety than non-dependent.

      CONCLUSION : Nicotine dependence is associated with depression and anxiety among Saudi University students.

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         Religions Identity in Egyptian Muslim and Christian Children  Aged 6- 13 Years / Rachel Allison Royle, Martyn Barrett, Yahya Takriti

ABSTRACT : OBJECTIVES : This study investigated Egyptian childrens religious identity, their attitudes towards and affective responses to their own and one other religious group.

      METHOD : 137 Muslim and Christian Egyptian orphaned children aged between 3 ans 13 years were questioned using a semi-structured interview which incorporated various tasks.

      RESULTS : Evidence was found to suggest that religion was a salient aspect of the childrens identity. There was evidence that some of the children were engaging in intergroup comparison, in-group favoritism and outgroup denigration as predicted by Social Identity  Theory ; this was especially true for the Christian children. The Muslim children did demonstrate in-group favoritism but did not appear to engage in intergroup comparison and outgroup denigration to the same extent.

      CONCLUSION : These finding suggest that childrens knowledge and attitudes in the religious domain may be influenced by the process of intergroup comparison as proposed by Social Identity Theory.

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         Factitious Disorders :. Sociocultural and Clinical Factors Among Saudi  Patients  /  Naseern Qureshi, Tariq AI-Habeeb, Muzamil Abdelgadir, Yasser AI-Ghamdy

ABSTRACT : Cultural factors are known to influence the epidemiology of various psychopathological syndromes. The goal of this article is to analyze the sociocultural and clinical features of factitious disorders in the light of Saudi culture. This case study comprised of five patients (male = 3, female = 2) with factitious  disorders who were identified through multiple interviews over a period  of decade, I.e., from January 1983 to December 1995.  At a sociodemographic level, most of these patients were characterized by lack of adequate  education, dysfunctional marriages and problematic large families. At an etiological level, multiple psychosocial factors fairly consistent with the international literature were traced in all patients. Clinically extensive raveling I.e., peregrination, pseudopathological lying and aggressive behaviors were less intense in females as compared to their male counterparts which could be attributed to cultural differences. Furthermore, four patients  uniquely consulted traditional healers whose responses were varied. It is tentatively summarized that some components of Munchausens syndrome (MS) are influenced pathoplastically by sociocultural dynamics of Saudi Arabia. Further researches across cultures are needed for unentangling psychological, social and cultural perspectives of factitious disorders which may finally lead to the development of novel culturally sensitive treatment strategies.

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         Self Mutilation / Hussein S. Hassan

ABSTRACT : Thirty-three psychiatric patients who committed self-mutilation regularly were examined an interview and special questionnaire were used to identify demographic & psychological variables related to this process. Results showed that majority of them were single, had miserable child hood due to death or emotional separation and they lift school early & had imprisoned many times most of them were alcoholic and drug abusers. Self-mutilation started early in life, usually after stressful life events that cause severe painful tension leading the patients to, direct the aggression toward them. The following blood gives great satisfaction and they feel no pain through out the process. While the main diagnostic references (DSM-III- R), put self mutilation in the diagnostic criteria of borderline personality disorder, 91% of patients were diagnosed as having antisocial personality disorder this results needs further study.

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