Psychiatric morbidity in Egyptian children with acute lymphoblastic leukemia and their care providers

Aim of the study: To evaluate the psychological morbidity of acute lymphoblastic leukemia [ALL] on children and their parents at different stages of illness and to assess the crucial contribution of the psychologist in the pediatric oncology team

Methods: We recruited 103 children with ALL and their 96 parents, and divided them into five groups according to disease phase: diagnosis, initial remission, active treatment, survival and relapsing. We compared these to 22 healthy controls and their parents. Patients and controls were subjected to clinical assessments, the symptoms checklist of the International Classification of Disease ICD [ICD-10], and the Wechsler Intelligence Scale for Children. The parents of patients and controls underwent a general health questionnaire, the ICD-10 symptoms checklist, rating scales for anxiety and depression, post-traumatic stress disorder [PTSD] assessment scale, and the physical cognitive affective social economic ego problems [PCASEE] questionnaire for quality of life [QOL] rating

Results: Psychiatric morbidity was evident in nearly 60% of leukemic children and their parents and was significantly increased in comparison to controls. Children mostly suffered from adjustment and oppositional defiant disorders. The most common discriminators between patient groups were conduct and attention problems being lowest in newly diagnosed patients, and social aggression being lowest in patients in remission. The three parameters were highest in relapsed patients whose parents mostly had adjustment and depressive disorders. Risk factors for child psychopathology were older age, female gender, and parental psychopathology. Mothers and parents with lower education and professional level were found to be vulnerable. Performance and total intelligence quotient [IQ] were significantly lower in leukemic children, and these were most pronounced in the survivor group. Risk factors for cognitive dysfunction were younger age, longer chemotherapy duration, and lower parental education level

Conclusion: Most patients and their caregivers suffered from significant psychiatric morbidity, highlighting the need for routine screening to improve psychological outcomes in such cases

Behavioral correlates of the nutritional status of the newly born infants

One hundred and two [102] healthy newly born infants were studied to explore the relationship between the nutritional status and behavior of the newborn infants. The biologically more mature infants i.e. In terms of birth weight and gestational age were more visually alert, less irritable and less active. With regard t infant sex, girls were significantly more visually alert than boys. With regard to parity, first borns showed increased activity levels compared with the second or born infants. Heightened irritability was associated with vaginal rather than caesarean section delivery and with use of anesthesia during labour. Twenty infants were classified among low pondral index [pi] for gestational age, they showed statistically significant lower behavioral scores especially on visual alertness and activity level measures. Of the protein fractions were found at a significantly lower concentrations in infants born by caesarean section compared to the vaginally born infants at the same gestational age. Neonatal physical growth was positively significantly correlated with the socioeconomic status of their families. Both weight, birth length, head circumference, mean arm muscle area as well as lean body mass were higher in the babies belonging to middle socioeconomic class families compared with lower class families

Psychiatric disorders among children with poliomyelitis

Study of the psychiatric disorders among 200 children aged 6-12 years, 100 of them presented with old poliomyelitis revealed that 62% of poliomelitic children were suffering from one or more psychiatric troubles in comparison to only 24% of the healthy children. These psychiatric disorders included behavioral [attention deficit and conduct disorders], emotional [anxiety and depression], physical [eating, sleep and others] and learning disorders. They were affecting all age groups, both sexes and significantly increased with increasing birth ovler, family size and low socioeconomic standards. In addition, they resulted in increasing familial relationship disturbances and psychiatric troubles. On the other hand, psychological assessment of personality type of poliomyelitic children showed significant high score in neuroticism, low score in extroversion and normal scores in psychoticism and lie, while their mean intelligence quotient was within normal limits and not affected by their psychiatric troubles. It was concluded that poliomyelitis leads to many psychiatric disorders and personality changes, so proper attention and management of such problems should be emphasized

Behavioral correlates to nutritional status of preschool children

In this study, nutritional status of 185 preschool children aged between 3 and 6 years was assessed by investigating dietary intake, anthropometric measurements and protein status. Results of nutritional status parameters were correlated with a battery of psychological tests that covered intelligence, memory, learning, thinking, problem solving and attention. Dietary intake data showed that 49% of the children had caloric intake and 12% had protein intake that were lower than the recommended dietary allowance. A significant positive correlation was shown between caloric intake and intelligence. Plant protein as well showed significant correlation with thinking and problem solving. Height for age showed deficit in 19% of the children when compared to NCHS standards. Percentage weight for age and height for age were significantly correlated to thinking, problem solving and to intelligence. None of the protein status parameters showed significant correlation with the results of any of the psychological tests

psychological profile of patients manifesting warts: an Egyptian study

A total number of 130 patients, sixty males and seventy females suffering from warts were selected from the out-patient clinic of the dermatology department within the age range 15-40 years. Psychiatric and psychometric assessment were done to the whole sample and the findings compared with those of a group of 70 controls. Psychological sequelae of warts were found to depend on the patient's personality, the basic type of the skin, predisposing circumstances and the characteristics of emotional reactions. A neurotic personality was found to be more prone to warts. Psychotherapy was of great help for recurrent cases where the warts reappeared in different areas despite proper management. Thus we conclude that continuous cooperation between the dermatologist and the psychiatrist is of great importance and in fact a necessity for the amelioration of the condition