Factors affecting recovery from obsessive and hysterical disorders

This study was carried out on 60 neurotic patients diagnosed according to the criteria of DSM III-R. It included 30 patients with Obsessive compulsive disorders and 30 patients with Hysterical disorders. In all patients the illness was either persistent or recurrent for at least one year inspite of active proper treatment. Clinical evaluation and psychometric assessment of illness were done using: Present state examination [PSE], Ego strength scale and life events questionnaire. Overall judgement of patients psychological and social functioning was done by the use of Global assessment functioning scale [GAF]. In both obsessive and hysterical patients, the duration of illness was found to he negatively correlated with the scores of Ego strength and GA F scales and positively correlated with PSE and life events scores. Meanwhile life events scores were positively correlated with the PSE total scores. Resistance to therapy and longer duration of illness were found to be associated with younger age of onset, more stressful life events, weaker Ego strength, severe or border line psychotic symptoms and lowered level of psychological and social functioning

Predictors of lithium therapeutic response in mania

Fourty patients diagnosed as Mania according to the criteria of ICD-10 were subjected to full Clinical psychiatric examination and psychometric assessment using Manic Rating Scale and Scale for Affective Disorder [SAD] derived from schedule for affective disorder and schizophrenia [SADS]. Investigations were done at the Start of lithium therapy and every week for one month, the dose of lithium was adjusted according to plasma level using flame emission photometer positive family history of affective .disorders was found to predict good outcome, while older age, previous depression, younger age of onset, paranoid features and formal thought disorders were found to predict poor outcome

Carbamazepine in the treatment of mania

This study was conducted on 44 manic patients diagnosed according to the criteria of ICD 10 and randomly assigned into two groups, carbamazepine treated group [N=24] and Haloperidol treated group [N = 20]. Treatment response was measured objectively by using Beigel Manic Rating Scale and Scale for Affective Disorders [SAD]. Beck depression inventory was used to evaluate outcome and detect development of depression after therapy. Carbamazepine has demonestrated substantial effectiveness in 50% of manic patients. Therapeutic remission occured mostly within 8 weeks after initiation of therapy. If after 3-4 weeks in the high therapeutic range a patient fails to respond, alternative therapeutic measures should be considered. Carbamazepjne induced therapeutic response rates nearly comparable to those induced by haloperidol, however, it showed rather more rapid action, better tolerability, less side effects and less risk for development of depression

Depressive illness in the elderly: psychosocial and demographic study

Sociodemographic, clinic and psychometric assessment of 24 elderly patients with late onset depression and 22 middle-aged depressed patients demonstrated that elderly persons were more likely to suffer from a single episode of depression often precipitated by stressful life events. Middle aged depressives were more likely to suffer recurrent episodes of relatively more severe depression. Few differences in symptoms emerged between geriatric depressives and their younger counterparts, these involved: greater self blame and suicidal ideation in middle aged patients and greater weight loss, somatic preoccupation, hypochondrical worries and psychomotor retardation in the elderly. Agitation and paranoid symptoms long thought to be typical of elderly depressives did not emerge as hallmarks of elderly depressed patients in the present study. Psychotic features did not distinguish the elderly depressives from their younger contemporaries. The findings of the present study indicated that neuroticism and stressful life events were important underlying factors in evolution of depressive illness in the elderly

Life experiences and the onset of schizophrenia

Using an Arabic version of the PSE, one hundred patients [20 with 1st schizophrenic episode and 80 with acute exacerbation] were selected from Psychiatric department of Mansoura University Hospital. Their life events histories for 4 weeks before onset or relapse were studied using Schedule of Recent Experience [SRE]. A positive association between stressful life events and onset of first schizophrenic episode was established. However, the role played by stressful events in precipitation of relapse was less pronounced. The nature of life experience may also influence the severity of illness expressed in PSE scores. The undesirable experiences were associated with higher PSE scores, while desirable experiences were associated with lower scores

Family expressed emotions and schizophrenia

One-hundred schizophrenic patients, selected from the psychiatric department of Mansoura University Hospital: were subjected to thorough clinical assessment using Present State Examination [PSE]. Mean-while Expressed Emotion [EE] of the patient's close relatives were assessed using the Camberwell Family Interview [CFI]. Relatives of the patients with recent onset schizophrenia were significantly more emotionally overinvolved and more warm towards their patients. On the other hand relatives of patients with relapse of previously existed illness showed more hostility and dissatisfaction towards their patients. Relatives high expressed emotions is proved not to be influenced by the duration or the severity of the schizophrenic illness so it's relation with frequency of relapse is mostly a causal one

Emotional attitude in relatives of schizophrenic patients psychosocial study

Camberwell family interview [CFI] for assessing relative expressed emotion [EE] was applied to relatives of one-hundred schizophrenic patients of different social classes and demographic patterns. It was found that high EE is not an independent trait, but it seems to be born in a climate of insecurity being more encountered among paranoid personalities, poor economic status and in parents who had lost their partners. The prevalence of high EF, doesn't differ between partners and parents, however, the kind of EE may differ. Parents are both emotionally over involved and highly critical towards ill children while partners are exclusively critical in attitude

Plasma T[3] and T[4] in patients with major depressive disorders

The material for the present study comprised 12 patients suffering from Major Depressive Disorders, 9 Normal healthy volunteers with matched sex and age served as controls. All patients and control group were subjected to thorough clinical psychiatric and medical examinations, psychometric study using Raskin's depression rating scale was also done. Determination of plasma T[3] and T[4] were done for control group and also for patients before and one month after antidepressive therapy with amitriptyline 150 mg/day. The results were discussed in light of previous literature and we concluded that low plasma T[3] levels in patients with major depression will induce a deficit in brain nor-adrenergic activity which forms the psychobiological bases of depressive symptoms