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THE ARAB JOURNAL OF PSYCHIATRY

Vol. 6, N 1, May (1995)

E.mail: takriti@nol.com.jo

 

 

q        CONTENTS / SOMMAIRE /  

 

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 /  

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.

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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.

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         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 Schneiders 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, Feighners, Schneiders 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 Schneiders 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 Schneiders 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.

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         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.

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         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.

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         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.

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         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.

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         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.

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         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.

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