Study of neurological soft signs in attention deficit hyperactivity disorder

This study was performed to provide data on the prevalence of neurological soft signs in children with Attention Deficit hyperactivity Disorder [ADHD] and detect its correlation with intellectual function and age of the child. Fifty patients with ADHD according to the DSM-IV criteria [mean age, 9.3 years, SD= 1.51 years] participated in the study. They were referred from the outpatient clinic of psychiatry at Assiut University hospital and from the private clinics of the staff members of neuropsychiatry, were evaluated with the Cambridge Neurological Inventory to assess neurological soft signs and Stand ford Binet 4th edition to assess the intellectual and cognitive functions. Fifty healthy controls matched with patients groups in Age, sex and socioeconomic state were assessed using the same tools. A significantly high incidence of neurological soft signs was fund in the patient's group and statistically insignificant among ADHD subtypes with significant negative correlation with IQ and age of the child. The Spearman correlation coefficient between NSS score and IQ and age are 0.672 and 0.283 respectively [p=<0. 001, 0.009]. Presence of neurological soft signs in ADHD is a non-specific marker of neurological abnormality but indicate poor intellectual and cognitive Junctions of ADHD

Translation; test for validity and reliability of the Arabic version of the edinburgh post-natal depression scale [EPDS].

Background: The Edinburgh Post-natal Depression Scale [EPDS] is a widely used instrument to measure post-natal depression. This study aimed to translate and to test the reliability and validity of the EPDS in Assiut city, Egypt, for ante-partum women

Methods: The English language version of the EPDS was translated into Arabic language and was used in this study. The questionnaire was administered to a consecutive sample of 391 pregnant women during 6[th]-32[nd] week at two points in time 15 days apart. Statistical analysis was performed to test the reliability and validity of the EPDS

Results: In general, the Arabic version of the EPDS was found to be acceptable to almost all women. Pearson correlation [to test reliability] was ranged between 3815* to 8485**. Alfa Cornbach coefficient found to be 8229**. Coefficient of mid-term retail was found to be 93**. The coefficient of internal consistency was ranged between 4573** to 7965** with significant P-Value

Conclusion: This validation and reliability study of the Arabic version of the EPDS proved that it is an acceptable, reliable and valid test of post-partum and also ante-partum depression

Epidiological study of depressive disorders among patient attending outpatient clinics of Assiut University Hospital

Depression is a common mental health problem, seen frequently in general medical settings. Primary care physicians are more likely to see patients with depression than with any other disorder except hypertension. To estimate the percentage of depressive disorders among patients attending outpatient clinics of Assiut University Hospitals, and to study the possible risk factors underlying these depressive disorders. This cross-sectional study was conducted during one year period from June 1[st] 2006 to May 31[st] 2007. 2034 subjects aged 15 and above were screened for depression using Beck Depression Inventory [BDI] scale. Subjects who scored 4 or more were further evaluated through psychiatric sheet especially prepared for the present work. Psychiatric diagnosis was made on the basis of DSM-IV TR criteria. Patients were also subjected to Suicidality sheet of the MINI plus and Sheehan Disability Scale. Depression was found in 202 subjects representing 8.8% of the whole sample, with 167 patients [82.7%] were classified as having major depressive disorders, 28 patients [13.9%] were assessed to have depressive disorder NOS [26 patients [12.9%] with minor depression and only 2 patients [1%] with postpartum depression], 5 patients [2.5%] were diagnosed with dysthymic disorder and finally 2 patients [1%] with bipolar disorder, depressive episode. Depression was significantly higher among female subjects, highly educated and literate individuals, non-working males and among divorced/widowed/separated individuals. Depressive disorders were also significantly higher among patients with Dcertain medical conditions [e.g. malignancy, disfiguring conditions, autoimmune conditions, renal diseases and hepatic diseases] and among those who had more medical conditions. The degree of impairment is significantly higher among patients with moderate and severe depression and particularly in patients with severe depression with psychotic features. Suicidality is significantly higher among patients with severe depression and particularly among patients with severe depression with psychotic features. Depression is a common mental health problem, seen frequently in general medical settings and necessitates close psychiatric attention and management

Psychiatric profiles in patients with liver cirrhosis

Psychiatric disorders are common comorbidities in patients with liver cirrhosis that may impair patients' quality of life. The purpose of this study was to evaluate the common psychiatric disorders in cirrhotic patients in our locality. Subjects and Psychiatric disorders were prospectively assessed by administration of Symptom Checklist-90 revised [SCL-90-R], Hamilton anxiety rating scale, and Hamilton Checklist of Symptoms of depressive illness to 200 patients with liver cirrhosis and 200 control volunteers of matched age. In addition, clinical data, abdominal ultrasonography and laboratory data [liver function tests for patients] were collected. Results. Compared with controls, cirrhotic patients were significantly more likely to have depression [43.5% versus 14%, P< 0.001], anxiety [16.5% versus 5.5% P< 0.001] and increased mean scores of SCL-90-R subscales ['e.g. somatizalion, depression and hostility,]. Increasing severity of liver cirrhosis [based on the Child-Pugh score] was associated with increased frequency of Psychiatric disorders. Compared with the control group, patients with liver cirrhosis showed significantly higher frequency of comorbid psychiatric disorders which is increased by worsening disease severity

Psychiatric aspects in hepatitis C infection

Psychiatric symptoms and emotional distress appear to be more common in chronic hepatitis C [CHC] patients than in the general population. The aim of this study was to assess the psychiatric disorders in hepatitis C infection in cases not receiving anti-viral therapy in a rural community of Upper Egypt [Sallam village]. In a cross- sectional study, 86 positive anti-HCV cases, aged 15-65 years old and 60 control subjects of matched age and sex participated in this study. Assessment was done using standardized questionnaires including Hamilton anxiety rating scale [HARS], Hamilton checklist of symptoms of depressive illness, symptom checklist -90 [SCL-90] and social scale assessment. In addition to clinical, physical, ultrasonographic examinations and laboratory assessment including urinalysis, blood sugar, hepatitis B surface antigen [HBsAg], HCV antibody and HCV RNA by polymerase chain reaction [PCR]. The mean age was 40.29 + 15. 75. Fifty cases [58.1%] were HCV RNA positive, whereas 36 cases [41.9%] were negative. The mean score of the nine subscales of SCL-90 were significantly higher in HCV antibody positive cases than in controls and the mean score of the nine subscales of SCL-90 were significantly higher in positive HCV-RNA cases than in controls except for those with paranoia. Moreover, the mean scores of the nine subscales were significantly higher in negative HCV-RNA cases than controls except for those with anxiety and phobia. The previous parameters were higher in HCV RNA positive than in negative cases but without significant difference. The frequencies of depressive cases [> 18 degrees] and severe cases [> 26 degrees] were significantly higher in HCV antibody cases [25 [29.1%] and 6[7%]] than in controls [3[5%] and 0%] [P < 0.001 and P < 0.05 respectively]. The frequencies of mild and moderate depressive cases were significantly higher in HCV RNA positive cases than in controls [P <0.01 and P < 0.05 respectively but only in mild cases for those with HCV RNA negative cases. However, the frequency of depressive cases [> 18 degrees] was significantly higher in both positive [16[32%]] and negative [9[25%]] HCV RNA than in controls [3[5%]] [P < 0.001 and P < 0.01 respectively]. There was a significant difference between mild anxiety cases [15-28 degree] and also anxiety cases > 15 degrees in HCV antibody positive cases [41.9%] than in controls 03.3%] [P < 0.001 and P < 0.001 respectively]. The same previous results were obtained on comparison of positive HCV RNA and negative cases versus controls [P <0.01 and P < 0.001 respectively]. Although the frequency of severe anxiety cases [> 29 degree] was higher in positive HCV RNA cases [4 [8%]] than in controls [1 [1.7%]] but without significant difference [P = 0.056]. No significant association was found between ALT levels and depressive as well as anxiety cases in HCV RNA positive cases and also, no significant correlation was found between the score of the nine SCL 90 subscales and the level of ALT in HCV RNA positive cases. Psychiatric disorders as anxiety and depression and also, the nine SCL-90 subscales were significantly higher in HCV RNA positive or negative cases than in controls. Although, the previous parameters were higher in HCV RNA positive than in negative cases but without significant difference. These results may be due to the patients concern about the potentially serious health consequence of CHC infection

Acidaemia, hypokalaemia and electrocardiographic changes after unmodified electroconvulsive therapy [ect]

Twenty-eight [fourteen males and fourteen females] psychiatric patients [sixteen had mood disorders, either unipolar or bipolar disorder and twelve patients had schizophrenic disorders] were studied for the effects of ECT on their electrolytes, acid-base state and on electrocardiogram [ECG]. Significant increases in both systolic blood pressure [SBP] and diastolic blood pressure [DBP] were noted in both first and last ECT sessions [ECT-S]. T wave duration decreased significantly in the first ECT-S only [0.624 +/- 0.204 vs 0.696. Correlations were done between changes in items and changes in electrolytes and acid-base state. Patient's acid-base status and blood electrolytes should be routinely measured together with a follow up ECG after ECT-S, especially in the elderly and in patients with cardiovascular [CV] disease. Unmodified ECT should not be used anymore in psychiatric practice except with appropriate precautions in non- risky patients