Schizophrenia and the rural Egyptian families

The emphasis on deinstitutionalization caused a shift of care of schizophrenic patients to their families.This study aims at examining family's burden of care of schizophrenic patients, family's attitude towards medical treatment- family's insight into the nature of schizophrenic illness and - the possible determinants of these attitudes in Egyptian rural family circles. 1- 140 1[st] degree relatives of schizophrenic patients were randomly selected during the year 1995. The prejudice of relatives against drug therapy was measured by a 13 statement scale originally developed in Greece, [1985] by Mantonakis et aI., and adapted by the author. 2- A number of factors, social and psychological, were examined as possible determinants of the negative attitude of relatives. These factors include age, sex, profession, education, positive family history and use of drugs 3- The burden of care was measured by a semistructured interview originally developed in India [1981] by Shila Pai and Kapur and adapted by the author. The prejudice against medications was very prominent in our sample. Poor education of relatives correlated to positive attitude towards drug therapy in disagreement with similar western studies. Both the socioeconomic and emotional burden were very prominent in a majority of the sample in agreement with similar western studies .As both negative attitude towards medication and burden of care of patient may play a very cucial part in determining patient compliance to treatment and hence the rates of relapse. They represent a point where clinical effort could be applied for the benefit of both patient and relatives. There is a need to develop an Egyptian family intervention program. It should be designed to use the resources of the family unit, it should be workable in rural population, and ingoing with our Moslem culture and background

effect of psychiatric consultation and intervention on the health outcome of G.I.T. patients

Psychological factors has been linked with both irritable bowel syndrome and peptic ulcers since the conditions were first defined. They used to be called psychosomatic disorders. Recently the credibility of the term psychosomatic has been questioned in the tenth edition of the international classification of diseases ICD 10. This study aims at shading new light on the relationship between the psychological factors and gastrointestinal disorders in terms of prevalence of psychological symptoms, personality profile, frequency of negative life events within the past year and the possible role of antidepressants and standardized psychotherapeutic intervention in the health outcome of the gastrointestinal patients. Ninety I.B.S. patients, 90 peptic ulcer patients and 90 controls has been evaluated for the above named factors. Depressive symptoms have been found very prominent in the patients groups. Patients have high neuroticism and introversion scores on Eysenk personality inventory, negative life events were more prominent in patients than controls with no difference between I.B.S. and peptic ulcer patients. The gastrointestinal symptoms become better after treatment by antidepressants and supportive psychotherapy. Depressive symptoms were also better but the degree of improvement was not correlated. Antidepressants play its role through its antimuscarinic effect sedating or analgesic effect in addition to its antidepressant effect. The authors concluded that the term psychosomatic is to be used at least to describe conditions such as I.B.S. which has been called functional before, specially if psychological factors proved to play a crucial role in its causation, course and cure

Hysterical pattern in Eastern Saudi Arabia

Seventy-two patients suffering from hysteria were seen in the psychiatric outpatient clinics at King Fahd Hospital of the University. A semistructured psychiatric interview and the standard mental state examination were used in assessing the patients. The incidence of hysteria was 5.1%; 48.7% were between the age of 11 and 30 years. The female/male ratio was 1.8:1, and 61% were single. Hysterical conversion was the commonest type [73%], and hysterical dissociation was rare. Twenty-six percent formed a distinct group with similarities to Briquet's syndrome. In 83% of the cases, a stressful situation preceded the most onset of symptoms. No gross deviations of intelligence were noticed in the patients, and the typical hysterical personality was rare