Vol. 23, N° 1, January (2000)www.imhotep.net\EPA.htm
q CONTENTS / SOMMAIRE
§ Leadership / by M.S. AbdelGawad
§ “Time Dimension” Revisited in Clinical Practice and Research in Psychiatry / by Y.T. Rakhawy
q Journal Abstract
q SUMMARY / RESUMES
§ Leadership / by M.S. AbdelGawad
§ “Time Dimension” Revisited in Clinical Practice and Research in Psychiatry / by Y.T. Rakhawy
§ Assessment of the Negative Symptoms in a Sample of Egyptian Schizophrenic Patients: Association with Poor Premorbid Social Functioning and Cognitive Impairment / by M.R.A. Raslan
ABSTRACT. The objective of this work was the study of the relationship between premorbid functioning, some clinical and treatment variable and cognitive functions of the schizophrenic patients from one side and the severity of their negative symptoms on the other side.
Method:. to achieve the objective, 63 Egyptian schizophrenic patients were recruited from Kasr El-Ainti University Hospital Psychiatric Clinic. They were assessed by PSAS, WAIS, SANS, BPRS and full psychiatric examination.
The Results: revealed that the severity of the negative symptoms was not correlated with the duration of illness or the duration of neuroleptic medication, or duration of hospitalization or the number of hospital admissions or the number of ECT sessions received by the patients. It was correlated with the severity of premorbid social and scholastic maladjustment, cognitive deterioration and age of onset of schizophrenic illness.
Conclusion: Schizophrenia especially its fundamental negative symptoms may be a neurodevelopmental disorder that manifest itself during childhood and early adolescence by maladjustment and during the active phase of illness by negative symptoms and cognitive deterioration.
§ A Study of Depressive Symptomatology in Cancer Patients / by M. El Batrawi and M. Moussa
ABSTRACT. This study compares depressive symptoms in a group of cancer patients (n=30) and a control group of psychiatric outpatients depressive (n=16). Assessment of depression was done by the Zung self rating questionnaire. Psychiatric depressives scored significantly higher in core depressive symptoms than did the depressed cancer patients. However, the symptoms representing the anxiety dimension of depression did not differ between the 2 groups. The implications of these results are discussed and recommendations for future studies are suggested.
§ Depression in the Elderly “Clinical and Psychosocial Study” / by A. El-Dod, G. Shama and A. Mubarak
ABSTRACT. Depressive illness is common in the elderly and has recently become the focus of much research. The number of elderly population is now increasing as compared to children and young adults and has led to an interest in the characteristics of this group of population specially their mental health problems which are considered a manin cause of disability in old age. In addition to the mental suffering, depression is a risk factor for subsequent morbidity, excessive health care costs and in some instances actual mortality. The prognosis of late-onset depression is relatively poor, and is characterized by frequent and prolonged relapses. So studying the problem of depression in the elderly is important in psychiatric health care. Sociodemographic, clinical, and psychometric assessment of 30 elderly patients with late onset depression and 30 patients with early onset depression demonstrated that elderly persons were more likely to suffer from a single episode of depression of longer duration often precipitated by stressful life events. early onset depressives were more likely to suffer recent episodes of depression. Few differences in symptoms emerged between geriatric depressives and their younger counterparts. These involved greater self blame, suicidal ideation, psychic anxiety in early onset depressive patients, and greater hypochondriacs, somatic preoccupation, psychomotor retardation and lare-insomnia in the elderly depressed patients in this study. Also, geriatric depression was characterized by cognitive impairment and functional disability, in comparison to the early-onset depressives.
§ Screening for Depression in Cancer Using the Zung Self Rating Scale / by M. El Batrawi, M. Moussa and H. Abdaal
ABSTRACT. The purpose of this study was to determine the utility of the Zung Self Rating Scale (ZSRS) as a screening tool for depressive disorders in cancer patients.
Method: Depressive symptoms were assessed in 30 cancer patients according to the Schedules for Clinical Assmment in Neuropsychiatry (SCAN). Diagnosis was made according to the American Diagnostic and Statistical Manual 4th edition (DSM-IV). The Zung Self Rating Scale (ZSRS) was applied on the same patients. Clinical diagnosis revealed 21 patients with major depression (6,6%), 14 (46.7%) with adjustment disorder with mixed anxiety and depression, and 5 (16.7%) with depression not otherwise specified. The ZSRS identified 17 of these patients giving a sensitivity rate of 80.9%. Also, from the 18 patients identified by the ZSRS as having depression only one was not clinically depressed, giving a specificity rate of 94.4% for the scale. Items which differentiated between depressed (n = 18) and non depressed (n = 12) cancer patients included crying spells, confusion, indecisiveness and dissatisfaction. Somatic symptoms including fatigue did not differ between depressed and non depressed cancer patients.
Conclusion :The ZSRS is an easy and valuable instrument in screening for depression in cancer patients.
§ Fertility in Schizophrenia in Comparison with other Psychiatric Disorders / by R. Reda Abdel-latif
ABSTRACT. This study has been done in psychiatric inpatient Unit la Zagazig University Hospital with the aim of comparing the fertility rate between schizophrenic patients and non schizophrenic patients. A total sample of 520 psychiatric patients having diagnosis of schizophrenia (n=180), Mood disorders (n=l 10) and neurotic illness (n=230) according, to ICD -10 diagnoses were selected. The fertility index was estimated and the Disability Assessment schedule was applied. The patient data were subdivided by diagnosis, gender, and family history of mental illness. The results revealed that the proportion of those ever married was markedly reduced in the schizophrenic group (FI) relative to those with mood disorders (F2) or neurotic illness (F3). Men with schizophrenia had a particularly low rate of marriage. The overall group (FI), only married men, particularly those with family history of mental disorder, produced more children than married women. So, there is evidence for increased fertility La schizophrenic men despite of decreased marital rate.
§ Benefits and Limitations of Conventional, EEG in a Psychiatric Clinic / by M. Al-Mahdi, R. Al-Gamal and M. Abdel-Fattah
ABSTRACT . The use and validity of EEG in psychiatric clinic is still controversial inspite of its reasonable acceptance in neurology departments . This could be attributed to many factors related to psychiatric disorders Them selves and EEG technology. lnspite of these factors EEG could be considered au important non-invasive tool for studying the electrophysiological functions of the brain la psychiatric clinics. This study is a trial to throw light on some benefits and limitations of conventional EEG in psychiatric clinic .
§ Linguistic Disabilities in Children with Attention Deficit Hyperactivity Disorder / by M.R. A. Raslan and Nahla Abdelaziz
ABSTRACT. The main objective of this work was to study the linguistic disabilities in à sample of children presented to psychiatric clinics with diagnosis or ADHD. A group of 24 children with ADHD was compared to a sex-and-age matched group of normal controls (n=24). Both groups were subjected to psychiatric interview using DSM-IV criteria, assessment of intelligence using Stanford Binet Test. Assessment of severity of ADHD was done using ADHD Rating scale and Swanson, Nolan and Peham - SNAP-Rating Scale. Comprehensive assessment of language development was done using, the Arab Linguistic Test (ALT).
Results showed that children with ADHD had significant delay in language development and this delay was correlated with the severity of the disorder. The children. The results were discussed in the light of previous reports on the subject.
Conclusion: Developmental language delay is highly associated with ADHD. The cause of this association is still unknown. The language assessment of children with ADHD is recommended.
§ Psychological Changes During Pregnancy: Relation to outcome & Postpartum Period / by M. Shaheen, A.Nasr and S.Abo El-Magd
ABSTRACT. This study aims to asses the psychological condition during pregnancy and some factors that may be related to it and whether or not it will affect the outcome of pregnancy and postpartum period.
A sample of pregnant women were assessed twice, first, during the last trimester and second, within 4-6 weeks after delivery. Assessment was done clinically and pychometrically using MMPI and BDI. The results showed that pregnant women got higher scores on psychastenia, hypochondriasis and depression. It was found that some factors like age were related to psychological state during pregnancy where younger women got higher scores on hysteria, hypomania and depression. Also low social class was associated with higher scores on depression, hysteria and psychopathic deviation, where as no relation was found between psychological state during pregnancy and social class or level of education. Regarding the effect of psychological status on the outcome of pregnancy, lt was found that C.S. and fetal asphyxia were correlated with high scores on depression, hypochondriasis and psychopathic deviation subclass of MMPI and BDI. Also, prematurely showed significant correlation with high scores on depression, social introversion and masculinity femininity subclass, whereas low birth weight was correlated with high scores on depression, schizophrenia and masculinity femininity subclass. Finally, no relation was found between psychological changes during pregnancy and postpartum depression.
§ Perceived Parental Styles in Depressed and Anxious Patients / by M. El-Batrawi
ABSTRACT. 30 Patients with DSM-IV depression, 13 with DSM-IV anxiety disorders and 20 normal controls were studied by the Parental Bonding Instrument (PBI).
On the whole, the 3 groups did not differ significantly on the parental care and over protection dimensions as assessed by the instrument. However, when the depressive group was subcategorized into a major depressive subgroup (n = 10), depression with psychotic features subgroup (n = 10) and adjustment disorder with depression subgroup (n = 10), significant differences appeared. Mean maternal care scores were significantly lower in patients with major depression when compared to controls (P < 0.05). Also, comparing the PBI mean scores between the depressive subgroups showed that the mean paternal care score in the patients with depression with psychotic features was significantly lower than that of the major depressive subgroup. Implications of these results are clarified in the discussion
§ Childhood Sexual Abuse in Depressed Female Inpatients: A 2-year Follow-up Study and an Explanatory Cognitive Model / by Alaaeldin Soliman and Safeya M. Effat
ABSTRACT. This study prospectively followed up a cohort of 75 depressed in-patient women for 24 months and compared those with and without history of childhood sexual abuse (CSA) along several outcome measures, including clinical measures, and measures for social adjustment and service utilization. Abused patients were no different from the non-abused In rates of DSM-IV major depressive disorder at one and two years. They, however, had higher rates ot dysthymic disorder, partial recovery, lifetime substance abuse, suicidal attempts and service utilization, and were more socially maladjusted. Analysis of depressive symptoms revealed a characteristic negative cognitive set linking CSA to depression in these patients. The results show that CSA is associated with poor outcome in depressed women and highlight the importance of preventive and early interventive measures of CSA. Management plans should carefully assess and specifically address the underlying cognitive dysfunction and psychosexual and interpersonal difficulties of these patients to improve outcome.
§ The Attitudes of Palestinian Primary Health Care Professionals in the Gaza Strip. Towards Mental Illness / by A.Afana, O. Steffen, E.Dalgard, B. Grunfeld and E. El-Sarraj
ABSTRACT. Objective: This survey sought to investigate the attitude of Palestinian primary health care professionals towards mental illness in Gaza Strip.
Method: A random sample of 166 General Practitioners and nurses were surveyed using Likert-type scale (29 items).
Results: Factor analysis revealed three main attitude dimensions western cognitive and community approach, emotional tolerance and reaction, and traditional attitude. Overall, older health professionals had significantly more traditional attitudes than the younger, where as the younger showed a tendency toward more western attitudes. Older health professionals showed more emotional and tolerant attitudes towards mental illness than the younger. Conclusion: Youngsters are usually the agents to introduce new concepts. Also, they are brought up with the frame of traditional values and conceptions, that can easily cause emotional as well as intellectual turmoil
§ Psychiatric and Emotional Disorders in a Sample of Egyptian Orphanage Resident Children / by S. Abdelmagd
ABSTRACT. This study aimed to investigate some psychiatric and emotional problems in an orphanage in Cairo. 74 Egyptian orphanage resident children were studied, age ranged between 9 - 12 years. They were equally distributed as regards gender. School children were matched as a control group for age, sex, and educational level . The sample and the control group were subjected to phobia scale for children, Children's Depression Inventory (C.D.I.), and psychiatric diagnosis using DS M IV.
The results revealed than the orphans scored significantly higher than the control group in phobic scale. Orphans scored higher in CDI but without statistically significant difference from the control group.
The most prevalent diagnosis in the whole sample was enuresis followed by conduct disorder, separation anxiety disorder, and sleep disorder.
RESUME. Les Désordres psychiques et émotionnels chez un échantillon d’enfants Egyptiens dans un orphelinat résidentiel.
74 orphelins et 74 élevés ont été soumis a l’échelle de phobie et de dépression.
Les orphelins avaient plus de phobie et de dépression que leurs contreparties. En plus, ils avaient plus de diagnostique d’énurésie et de désordres de conduite (selon le DSM-IV système de diagnostique).
q Journal Abstract
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