Epidemiologic assessment of substance use in the Arab world

Epidemiological studies on substance use are rare in the Arab world. The purpose of this paper is to present a systematic review of all published epidemiologic research in the Arab world up to 2007 using several search engines such as PubMed, PsycInfo, and IDRAAC web database. Research in the Arab world was conducted on specific subpopulations ranging from students to autopsies, at times on large numbers and only one published article on a national basis. Despite the rigid laws against substance use in this region, alcohol is the most used substance, especially among high school and university students ranging from 4.3% to 70.1%. Males use substances more than females except for tranquilizers and barbiturates, the trends changing in a recent report from the L.E.B.A.N.O.N study. As reported by Western counterparts, substances carry a burden on several levels including social impairment, problems of violence, and HIV. Risk factors for substance use include mainly family problems and peer pressure. However, there remains a clear need for national data on substance use in the Arab world in an attempt to identify the magnitude of the problem, and track it for proper monitoring and intervention

Egyptian contribution to the concept of mental health

This paper provides a historical look at the Egyptian contribution to mental health from Pharaonic times through to the Islamic era and up to today. The current situation as regards mental health in Egypt is described

Effect of a training program on physical fitness and serum levels of lactate and lactic dehydrogenase enzyme in beginner boxers

This study was designed to investigate the effect of a suggested physical training program on the level of physical fitness and the serum levels of lactate and lactate dehydrogenase enzyme in 30 male volunteered beginner boxers. Also, a special interest was focused on the relationship between the changes in both physical fitness and the serum biochemical parameters. The results showed that exhaustive muscular exercise caused significant increase in HR, Mean ABP, serum lactate and LDH either before the training program or after it. The results also showed that a training program of 3 months duration caused significant improvement in physical fitness parameters with significant decrease in serum lactic acid and significant increase in serum LDH. The results showed significant correlations between the physiological parameters and the biochemical parameters. So, it could be concluded that measuring serum lactic acid and LDH concentrations, in addition to the physiological measures, could be beneficial in designing and follow up of training programs

Assessment of psychosis in schizophrenia and affective disorders by a locally constructed rating scale

This study tried to investigate the notion that psychosis is not synonymous with schizophrenia. Psychiatric symptoms are not unique to a particular psychiatric disorder but rather a measurable dimension underlying different disorders even those of neurosis. A sample of 117 patients labeled with the diagnosis of schizophrenia, 56 patients with affective psychoses and a control group of 25 patients with neurotic disorders were investigated. Psychosis was assessed in these patients using a locally constructed rating scale compared of five dimensions, these were: loose association, delusion, hallucination, personality deterioration and passivity experiences. The results were discussed in the light of the psychiatric profile and it was found that psychosis is found in different patterns among the studied disorders. Schizophrenia was found to be a heterogeneous disorder and bipolar affective disorder was found to be of more severe psychosis than unipolar disorder

study of 13 diagnostic systems [criteria] for schizophrenia on an Egyptian sample: frequencies, agreements and validity

We compared the frequencies and agreements of 13 systems for the diagnosis of schizophrenia: Schneider; E.Bleuler;M. Bleuler; Langfeldt; Kraepelin, North America; Great Britain, Dongier; WHO-CSB, Yusin; Newmark; DSM-III; and Feighner. We tested also the validity of five of these systems as their concordance with clinical diagnosis and their sensitivity and specificity. The sample consisted of 200 newly admitted psychotic patients at four psychiatric hospitals in Egypt. Patients were assessed by the Arabic version of Landmark's questionnaire for the assessment of schizophrenia which is constructed to cover the requirement of the 13 systems, it showed that the 13 systems varied much in comprehensiveness. The highest agreement was between systems that specify the type of onset and course. The validity study supports the usefulness of DSM-III, WHO-CSB, and Langfeldt's systems for clinical practice. Feighner's criteria were the most specific for biological researches and Schneider's criteria were the least specific as they are unable to exclude other forms of psychoses

Validation of PSE/Catego computer programme on Arabic population

The validity of the PSE/CATEGO computer programme is assessed on a sample of new 100 psychiatric Arabic patients. The CATEGO based ICD-9 diagnoses were compared to the consensus clinical ICD-9 diagnoses. A "good" overall agreement with Kappa = + 0.71 was achieved for the 3-digit ICD-9 diagnoses. Most disorders have a very good agreement except for paranoid disorder [Kappa = + 0.71] and neurotic disorders [Kappa = + 0.71]. The Index of Definition [ID] suggested cut off point of 5 and above was found to be too high for our sample as it was likely to undetect 10% of cases. The results are discussed with the suggested changes in the CATEGO programme to suit Arabic patients

Brain mapping in suicidal and non-suicidal depressives

Reports and experience reveal the fact that 15% of major depressive patients will commit suicide. Do those suicidal depressives constitute a special sub-group of depressives? Can we predict by some markers those with high suicidal risk? CT findings, neuropsychological testing and EEC showed abnormalities in a sub-group of depressives. Previous findings have reported a low 5 HIAA of the CSF of suicidal or violent patients. Through BEAM studies, previous authors have attempted to separate paranoid and non-paranoid depressives and depersonalized and non-depersonalized depressives. This study is an attempt to differentiate between high risk suicidal and non-suicidal depressives through BEAM. Our study showed encouraging results in that, with more cases, more modifications and more statistical analysis regarding amplitude, power and distribution, we can develop a possible neurophysiological marker for high risk suicidal depressives thus giving better prophylaxis and caution. Our findings showed that 64% of suicidal depressives show the right parieto-occipital dysfunction seen in the non-suicidal depressives with temporal extension

Is it worth treating cases of heroin abuse as in-patients?

One hundred admissions of heroin abuse in a psychiatric unit were studied retrospectively for their compliance and adherence to hospital regimen. 64% ranged between 21-30 years of age, there were 92% males and students followed by merchants were the commonest population group [39% and 27%]. 71% of patients stayed less than three weeks which is the minimal period for hospital treatment and they discharged themselves against medical advice. 57% were admitted once, 22% twice, 12% thrice and 7% more than thrice. There is an obvious waste of psychiatric beds especially in developing countries where outpatient treatment of herion abuse is discouraged. These facts should outline the strategy for the treatment of herion abuse

Prevalence of depressive disorders in a sample of rural and urban Egyptian communities

This study met the criteria of community samples in which the respondents have been directly contacted. The prevalence of depression among selected sample of an urban and rural population were found to be 11.4% and 19.7% respectively. Adjustment disorder was the most common category of depression in rurals, while dysthymic disorder, was the most frequent diagnosis in urbans. Demographic data revealed that depression is more prevalent in the age groups [18-35 years]. A high risk of depression was associated with female sex. The authors believe that such information will be necessary for planning mental health programs and for calculating the costs and allocations of health resources in the future

Academic underachievement among Egyptian children

To understand the factors leading to academic under achievement among Egyptian children, 118 Rt. handed boys were randomly chosen for this study. Other cases of underachievement i.e. organic brain dysfunction were excluded at the start of the study by complete neurological assessment, E.E.G., language disability test and I. Q. testing [18 were excluded]. The rest [100 cases] were subjected to anthropometric measurements, complete physical examination, psychiatric interviews, stool and urine analysis, a standardized parent questionnaire, a teacher questionnaire, psychological assessment for intellectual abilitics and personality traits. Disturbed family background, emotional disorders mainly anxiety and depression, behavioral disorders mainly conduct and oppositional, personality traits including neuroticism, introversion and psychoticism were the factors that significantly correlated with academic underachievement, while other factors including the mean I.Q. did not. Effective management should be multidimensional including the child, family, teachers and teaching methods

Hemodynamic changes and glucose utilization during controlled hypotensive anesthesia with labetalol and sodium nitroprusside

This study was carried on two groups each of 10 patients undergoing major maxillofacial or orthopedic operations. Hypotensive anesthesia was conducted using SNP and labetalol. Labetalol produced hypotension without tachycardia which was evident in the SNP group. Blood sugar increased significantly in both groups. Serum insulin level decreased significantly in the SNP group, while in the labetalol group it showed an insignificant increase

Tardive dyskinesia in psychosis: a study of its prevalence, psychodemographic and clinical aspects among neuroleptic-treated Egyptian patients

A survey study of T.D. among 3037 Egyptian psychotic inpatients under long-term neuroleptic treatment was carried out. 52 dyskinetic cases were detected, and the prevalence rate was estimated to be 1.7%. Significant associations between T.D. and age at examination [above 40 years], female sex above 50 years, and duration of hospitalization were detected. The relative contributions of other variables in the development of T.D. were far from clear in the present work. T.D. movements were mostly central affecting commonly the lips and jaw, frequently in the form of chewing, smacking, pouting, puckering and grimacing movements. The degree of severity was mild in 61.57% of cases according to the 'AIMS'

Descriptive study of attempted suicide in Cairo

A sample of 91 persons who were admitted for attempted suicide to the casuality department of three hospitals in Cairo during the year 1981-1982 were thoroughly studied. The vast majority of the suicide attempters were young women [age range 15-34 years] belonging to large overcrowded families. They showed a higher tendency to be single, literate and unemployed than the corresponding age group in the general population. Drug overdose was the commonest method used. The majority made their attempts at home when there was somebody nearby, and 31% had previous non serious attempts. Dysthymic disorders, adjustment, affective and personality disorders were the most common diagnoses encountered. Attempters scored higher in neuroticism, extraversion and psychoticism and they tended to be more flexible

Parkinson's disease visuoperceptive disabilities and cognitive deficits

Visuoperceptive disabilities in twenty right-handed patients with idiopathic Parkinson's disease [PD] were tested. No significant difference was found in the patients using the WAIS performance subtest. Although insignificant, yet individual scoring of patients with PD showed that there are difficulties in visual motor coordination and performance conceptualization. These difficulties might underline the mental rigidity and inflexibility of PD